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06/30/2005 09:58 714-4, 2110 TERRACON PAGE 01 <br /> SAN ,oAQuw Couny <br /> ENVJ.R0NMXNTAL HEALTH DEPARTMENT ♦y <br /> 3 0 2005 304 East Weber Avenue,34 Floor,Stacktoti,CA 95202-2708ov. r8chd <br /> ENVIRONMENT HEALTNrelepTiflue:(209)46&3420 FIX.(209)464-0138 Web:www ag <br /> PERmIT/SEAMCES PUBLIC RECORDS n'UASE APPLICATION <br /> �QpS <br /> BllSN'LESg►���; <br /> APPLICANT: !(,ua <br /> APOM ACSiM <br /> �/zj ZZ PHOti�(7I� TWO <br /> rr ust ce cone) <br /> TEWATIVIE*A�NT QA date of +a on sue„atta� 'nn <br /> M a stmocos DAYS <br /> (purge*tow 10 bc�n�dW ONLY)_RFavEST s <br /> Ca WX Td iW�REauMY- .00 ( DATE <br /> SIGNATURE OFµppt.ICANrt a Olivar(cled> "� �) <br /> C7Ue#1 <br /> d U 2 Wt 3 j*4 Unit b Q Wilt4 <br /> EMD USi+ONLY <br /> FILE Atyat�ss , p S <br /> . Strpet� StrestNa�no a <br /> -7111 <br /> I� 7 ` <br /> 2. <br /> a. <br /> 4. <br /> s. <br /> s. <br /> 10. to <br /> Specific late Ria of inlo"ation Etequcs%d;From FILES <br /> ENYIRONIMlEWAL H�-'M DEPARTMENT <br /> ra sopow4v_FACUrdVOOL, <br /> TM <br /> URUBsaA100 TAW cus'f)Ca.F..HW'&�(LOP) a F err p ca�m� <br /> Sr Rl -i- COG lCtN 91 Trtarrt Duerr <br /> Q <br /> AW y M C t�wlst tti ► Taa ns <br /> . p putTRucedYa <br /> d Ytr �Tm° � d Poo C LAM Use/1pvNcwtHeN 5i <br /> 13 Tw'rroclt n aF14eR UW - <br /> n tA2dc++L Wuie F,►cacm Reoon� avan.ael t w_ Y ei�aY a:oo 1° ct►eCktng the <br /> �"D select the type(a)off des from the llst atbove by d <br /> Ce abode. selected• to 209 464-813g ar mail faD e <br /> i. list up to, addressIlk thie least one fife type MUST be t asststmlce with file a►ddres.aes,rsontgett <br /> apprnp�bo.4 )- will not be a�®irted'^for addltlolta lnes�day. <br /> Ind icat®d alxar►e. Address rangy. 3.00 PM will be processed the next bus <br /> the S Applications received after tiles exist- An apPolntn'°nt for review Um of bU$lness <br /> t tf any EHD The files will be held for a triatxi <br /> Z. The FHO wlll nvtnY tt�o apl after receipt of appavatwn. <br /> 4ppewdinataly teh(14)days <br /> days far review- Ap�y(�ent$should be scheduled aoco t be immediately LvjW,40 for i'eview- A new <br /> 3. A Elle that n actively <br /> s being who wit► n theon yfiiei�s available. EHD staff at the expense 8f the <br /> aplitiratio will be reor9anixed by <br /> 4. apY file not returned In the <br /> b�conddonhe same aWll [►Y require a$93-00 deposit Poor to review, - <br /> applicant. Future Tile . <br /> M <br /> 1=344 <br /> TO 391dd HL-VH -1d1N9WKR11IN9 8£T0t�9ti 69�TT g06�/8Z/9 <br />