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r <br /> 1640123 ENV:R0RA7J,lTAL HZALTH PAGE 01 <br /> 8/2 14: 0 <br /> SAN JOAQUIN COUNTY <br /> F-NVfRONMENTAL 11EALTij DEPARTmEN"f <br /> 304 East Weber Avenue,3d Floor,Stookton, <br /> V. CA 95202-2708 <br /> (1c)ePhone;('209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/eh <br /> o3rg/ch <br /> . .................. PU(,B.TAC ]RECORDS M&LEASE APPLICAUON <br /> APFUCAN'r--LAfN <br /> ADDRESS: R111%0' <br /> PHONE PHONE(2): <br /> TENTATIVE*Appowiv"T DATAMato: -7 <br /> . <br /> (Please allow 10 b"n=dWA from date Of2ppiloationsubmittal raniammomy-must be canfimu <br /> CHECK BOX TO EXPEDITE PE <br /> S. FEE(CASH ORUF-CKONLY) RrmmSt mu <br /> ocsEr),iN 313USIUMS DAYS <br /> SIGNATURE OF APPLICANT <br /> RATS I J Y W <br /> ii <br /> Electronic information; []List map—Dwwdplion; <br /> FILE A0,PRE5S EHD LISE ONLY <br /> $treat# Street Name city unit I <br /> fiLl ,tk ICS- <br /> E. '56 <br /> 3. /1!10-u <br /> 4. �Unft 3 <br /> 5. <br /> "Unit-d <br /> unit s <br /> 9. <br /> Unit 6 <br /> 70. <br /> $pacific Data Range of Information Requostad:From to <br /> ENVIRONMENTAL HEALTH DF-PARTMENT RUPS <br /> UKDEN',RO"TANK(UR CLEANUP SITE(LOP) 11 HoLmm AnATEAdENT Lmr-ZOM WASTE 17 AC1QTY1VkWCL15 <br /> POZHER CLEWO-op bin(NON-Lop) 13 FOOD FACa "AM TIRE <br /> 1JN0&7C4UXM TANK(L10K1TQRMtC1R-f0VAA,) C3 Dog KeMEL C]DAIRY <br /> HAZARVOUS WAITE GENRKATQR M MOMEN RA <br /> FLWASTEWATUR TkFATMENT PLANT <br /> TUMM PffRldr=FACIM 13 Moleiii-ionL 1:F`wmPF.K-TKuCWYA*w1CVcMTuLm <br /> eRc3NQ 0 PPOUSPA 0 LA=USE APPLIcA=N Q� <br /> lu=WUPTACILITY C3 OrHrLg(P4Azo Spr-CFy) <br /> Wee AHD SMc Pwom RLcoRDSARE AVAILAaLt FOR Rrvxw- UOMAY-MvAy 11,00 AM-5:00pm - U=0940 KOMAYt. <br /> 1 Llzt up to ter;addr=os In tho space alwVe. Select the typT(G)Of files from the tst above by cha"g the appropriate <br /> box(es)- At least one file typo MLIT ba saloctad. Fay Lo(2.0)A& 0138 or mail to the add-Ks k d'lGat*d ah2yR. Address <br /> ranges will not be accepted,for additional assistancu with file addressm,contact the EHM Applicatl Qns rec61vtO aftar <br /> 3:00 pm wal be processed the next business day. <br /> 2. The EHQ will inotifythe applicant If omyE14D files exist An appointment for Taview w31I he c9nfirmd appro4mataly ten(10) <br /> days aftor receipt of application. The files will be held for a maximum of fivu buSIrloSs days for revjaW. AppointmentS <br /> should ba scheduled accordingly. <br /> 3. A file that Is actively being worked an by 151-10-staff may not be immediately evallable for rovlaw. A now application miq be <br /> subrNtLod when the 1110 Is available. <br /> 4. Any file not returned In the same condition as raluased will be reorganized by IM staff at the expense of the applicant <br /> Future file ravlaws by the same applicant may roqWtv IL$95-00 deposit prior to review.,_ <br /> END USE ONLY <br /> EtM4a-a w't=5 <br /> TO/TO 19Vd SiNVI-inSNOO I]V 66099vtSZ6 CC:bT 80OZ/6T/80 <br />