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FROM 5IEF2fZR WEST-BRIGGS+LAND PHONE N0. 916 985 0786 �ug. 20 2004 08:40PM P2 <br /> ., <br /> 03/20/2004 10:53 45�L1 ENVERONMEN-AL HEAL.'iH �- PAGE 61 <br /> anti.wvv...n.0 <br /> D SAN J OAQUYN COUNW <br /> W/ � tr4w ON-INIENTAL HEALTH DEPARTMENT <br /> 304 V,Weber Ave P Floor Stockton, CA 95205 <br /> AUG 2_-3 20)468-3420 Fag! (209)464.0138 web:wvvw.co.san-joaquin.ca..us/chd <br /> ENVIRONMENT HEALTH PUBLIC RECORDS FXLEA IE OPLICA,TION <br /> T <br /> APPLICANT: w �Lwc �x� �S Bt1Sfi�iESlIIABL�lCY: �1 2>2 Sr �tLUxt i C�.I.j <br /> �agol:>=ss: �oZ°� SLt-t E��+2 i SC ,1C. ,� QI 30 <br /> are: t �SFACSIMILs:, X716 PJ8S _ �18� <br /> TENTATIVE"APPOINTIVIEW DA7:,... <br /> (Ploase allow 10 business Omm fmm d&W cf 4 01511MOOn subtllittai) <br /> X(ct,EC K Box TO EXPEDITE 1RNQUE3T_3§ f:E-RFQtJ E88211 IN BUSINESS DAYS <br /> SIGNATURE Gl`APPLICANT DAT8I�� <br /> De"TCnant U98 ONY <br /> rr <br /> FILE AADR>eiffi <br /> ,. 9 15{5 W. C" E.Flew-8- ST ;& Unit i <br /> Rion _IydZo" <br /> 7 <br /> ( nit 2 � <br /> F$wet _ ntt 3 <br /> ' t)nit 4 <br /> e. 6 <br /> s 'ear <br /> "V1ftGNMENTAi HEALTH DEPARTMENT FILES. <br /> a HOUSWIa ;AISATEMENT 0 SOLID WASTE F <br /> ACffi <br /> UNI3fftG1t0UND TANK(UST)CLSN4NL�'81i>w(Lop) 0 FOOD FApI 17r C3 wUO WASTE�� <br /> TF{SR.cLEMUP SIZE(NON-1.013) <br /> UNDERGROUND TASK�+tpNTTORINC41R1:MlQifFW. o CHICKEN RANCH b PICC TREATMENT PLANT <br /> C3 HAxAMous MSTE ORNE RA.TOR itiOTl11I14 1 © pumpER1RUCKfYARS7lG�{EM TOIU; <br /> Cl TIERED p9RMt'1' D FAG1UTy ❑ �aouBPA is UVM USE AIiPI-ICA11oM SM:S <br /> C7 TATToatBADY PIEfROWS C3 OTHER tPLEABE SPEC1lm <br /> 0 MEDICALWASTLFACILITY <br /> 1. List Up to tor!addresses In the space above. 501"t the VWS)of flim+from the Itat a(�gye tsy ot�ecking <br /> the appropriate bvx(AS)• At bast onu filo typ <br /> e lI1lTS1"be selected. 2C9 o rllall to <br /> t Intxnent for review will be confirmed <br /> 2. EHp will notify the sppttcarlt f!any Et tlatir than <br /> t. Art app° after r*lpt of sp.plication. Tile filva <br /> spproximatety flue b"nesa d#ya bui tta later thaf r (10)d>sys Appointments Should bs eehedul" <br /> will 1>s hold far a maximum of five I�vaines*days far r+2viariv. <br /> ucc,ordingly. I aivailabte for r01/lsw. Anew <br /> 3 Attie than is Ilt&ely being wW*od an by EHD staff Inay net be Immedtacs y <br /> itpp(lygtion mtsy bo submitted whbn the file is Ilevaitanlo. nirAd 4y EHe stn#i>at ttla exDsr+as <br /> 4. Any file not retrSrrsad In the same condition <br /> the as retcapp will bo re g IM a$93.00 dept#Prior to rovtew. <br /> of the applieanL €uturs fife raviOws by the same a 1iCalnt mAy req <br /> *TENTATIVE appoirrtl'nent dates must be,Confirmed <br /> P i ee ed a na with EHO sftff- ess day. <br /> 6. - Applications receivedRU <br /> after 3:48 pm <br /> Y1M>= <br /> LDATFEE <br /> W l"M�D APPOlNTI4IENTF OAT>= - IN[YlA1.S- , <br /> PHONE • FAX <br /> CONFIRMED �,, ..- - — V(E+V pA'1>t= <br /> ViEM <br /> YES NO <br />