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Jk4-11-1996 13:07 FROM GEOLOGICAL TECHNICS TO R 4640138 F.02 <br /> EH oO 14 (REV 5/94) � SAN JOAQUIN COUNTY �f'_ <br /> LIC HEALTH MVICFS <br /> ENVMONMIENTAL HEALTH 1)MS <br /> PUBLIC RECORDS ItELF.ABE "p[ACATI()N <br /> APP CANT PHbNE rtADDkESS <br /> 0 <br /> AGEKY NAM :' PH <br /> ONFi NO <br /> ADDRWS 1 ' <br /> ADDA S CaLt- }rtzot rte 5 LFAV__QMKY_ <br /> ' r.�i E�tonf f.A <br /> 1174a STA J F:S�R VS.an?&t7 <br /> -- __ sac-nNs-E�� � ►I �� ` =,� <br /> Ill�- e raG�'•►1.� F)��srr.e ,• ., ., ,r ;, �, i �. <br /> j E rasp nz <br /> o /�lDS <br /> 6C-17-ii;KC[fc.,.t,e�,s h uE v r r <br /> 1 ii s t: <br /> { jj <br /> J^{kpp�jUF_ a S•it <br /> i <br /> THIS Nall is su87BCT To THB REQUMEMENTS MatMMED IN THE PUBLIC HEALTH <br /> SERVICESIM KOI MENTALim-AL7H DMSION(FHB)POtiCY#94-W7.ORDMANCE CODE aF SAN <br /> JQAWN CO NTY, #MD -ESS AND SHRVICIj QL4RGB RESOLUTIONS, STATE WATER CODE, <br /> CoYERNmEr0r CODE AND THE EYIDFtYCE COD&. <br /> { <br /> 1. A MA3 LMLIM OF TEm (10)p2li,eleg ADDujssss rte ItGQuEsr. <br /> 2- Pusu: FILPs/RECORDS REVIpW is gy A.l'POINTME;N't'ON -Y: APPOittiM&Ivta ARE ARRAN-CMD BY <br /> CALUNd (2".03400 OpFM XOVPa FOR APPOtKCAtMM ARE 'CMFMULED MOttDAY TtTRU FRIDAY <br /> EXCLUDINQ HOLIDAYS, 8:00 AM TO 13:410 NOwa AND 1:00 PM•£0 4:30 FM_ <br /> 3. A PUMC RSCORM ABLE,{.,*$APPLMA- ION(PARA)Is RBQUiltED. <br /> 4. ; FURt-W;pLLESg RECC)PM Nrn']MUMED IN THE SAME COMMI'ION AS RECEIVED WILL BE CORREC'2W <br /> 8Y THfi'F-HL GAFF AT THU MENSE OF TUB APMXANT. TjW ADDRIONAL SERVICE Wit-L 8fi am4_;iD TO nIE <br /> AP}LXAlfr FOR PAYMb7 r (SM EHD FOLX-y"-(XM <br /> s- OMLN*L Ptfazlc!F111MRECORDS BRALL NOT jr,RatovFri-PROM TRE EHll PREMISE4. <br /> , . <br /> 1 <br /> SIGNATURE 0#APFUCANT bA7E (! - <br /> SiGNATURg OF RfiLZAStNO aFFlCiA1r DATE <br /> No PUS/mm!Pjw0R$PFMM ARB IDSNTWUM, <br /> �"t rtr�w.�m nwmcwnar oNttir. <br /> PHSJIrHi7 Rt vRIaelFh.ss ss=r OttTon 'PAMRl'WES)NO17dD. YOU WILL lid NOTtnZA w"RN <br /> cam m...r. <br /> I / fkgwxw for PAM <br /> �b ���1 l<` \.:,�� 11'1-.;'j 1 } �'il .,( 1 ��Lt_� .I .k_ ��.v X. Irl li �l f.rr!-r�,�• / ��1\C� `-�1 } �; r'( I �(., > <br /> ��, C L L. Cz •`_i �c r ��. J TO HL P.172 <br />