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,_--12/06/04 MON 15:28 FAIR 415 '13 5480 TETRA TECH EM INC F- Z 0 <br /> BATE REC> iVEb E-HO LOG NUMBER <br /> SAN JOAQMN COUNTY <br /> ` ENV )NMENxAL HEALTH DEPA�2'1'N.(EN'� <br /> 304 E Weber Ave P FjWr Stockton, CA 95205 <br /> 209)468-3420 Fax: (209)464-0138 Web: www.co.=-joaquiiLcau-1L/chd <br /> DEC � zob� <br /> PUBLIC RELEASE AFPZ,ZCA' 'l[6�I`�t <br /> �PPI�dAwtER`Jl�r� G� 4� �'IBUSUIESSIAGENCY: <br /> ADDRESS: /Z0 cv �/'. /� <br /> PHONE �J - a 2,7 FACSIMILE• 7/s 5 <br /> TENTATIVE`APPOINTMeNT DATE: Tlmoc <br /> (Please allow 10 business days from date of app1laa6on submlttaf) <br /> Q CHECK BOX TO EXPEDITE RLQUEST-39 PROCES D UJ 3 BUSINESS DAYS <br /> SIGNATURE OF'APPL.ICANT <br /> oarE /260�� <br /> Department Use Only <br /> UNIT <br /> na ADDRESS <br /> W M-1 ff ewe R �tu'r D u "t t J-? <br /> 117 <br /> 2. svee+ w kae R vL <br /> a `I Sl Y �� 7 [] Unit 2 <br /> o. sues D w <br /> 4&2dlUnit 3 \r`F <br /> S. s� �:. Z Yo <br /> s. <br /> Zee N J �. <br /> _. <br /> Unit a <br /> ? 04w, nit 5 <br /> n 1L,()cu <br /> � NV1R NMENTAL HEALTH DEPARTMENT FILES <br /> ❑ HOUSING AFLATEMENT ❑ SOLID WASTE FACI <br /> f'f AN <br /> NDEROROUNO TK(UST)CLEANUP S►T15(-op) ❑ FOOD FAc1UTY ❑ SOLID WASTE VEHl <br /> 'Cf OTtjER CLEANUP S T'E(NON-LOP) O DOG KENNEL 0 DIPY <br /> (� NDERGROUNDTANK(MONITOPJNG1REMONAI) 173 PKGT <br /> PEATMENT PLANT <br /> HAZARDOUS WANE GENERATOR O CHICKEN RANCH [3 PUMPER TRUCMARDrC <br /> HEM TOILETS <br /> Q TIERED PERMrrrEv FACILrry p <br /> O PooLLIPA ❑ LAND USE APPLICATION SITES <br /> n TATTOOIBODY PIERCING O POOoTH (PLEASE SPECIM <br /> 17 MEDICALL.WASTE FACIL.fTY <br /> 1. List up to ten addresses in the space above. Select the types)of flies from the list aboye by checking <br /> the appropriate box(es)- At lea-.t one file type MUST be selected. Fax to 209}464.0138 or mail to the <br /> address indicated above. <br /> 2. EHd will notify the applicant if any EHD riles exist_ An appointment for review will be confirmed <br /> approximately five business days but no later than ten (10)days after recelpt of application. The files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immediately evaltabia for review_ Anew <br /> application may be submitted when the file Is available. <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review <br /> 5. "TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> t7NFf} Mf M DATE TIME <br /> t3,4TE C13ifFIRP�IEIi PHONE FAX: <br /> I �YIEWiwl3 Y>rS NO REVIEW DATE. <br /> IZ-r 3 U '(Q( �9 act 'f5`/ �—�v �'£r <br />