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11/19/2003 11:20 464911 <br />EtrVIRMI (TAL. ( tel <br />[GATE RCMVED <br />SAN <br />Quz <br />Etr'•lu�HmErr�rALr�avyCy`('rr� <br />��wm&N <br />304 E 'Wrebar Ave 3"' Floor Stodkwn, CA 95205 <br />NO V 1 9 20(f3M 468-3420 Fac_ (209) 464••o139 Wc-'bs %vww.ca-sen joaquinx-Lush:hd <br />PAW H1 <br />E u W15.%Jum Stl, <br />AWPL.t�; _ ;(��T�f � EEh! � 1 SG+f � Busnt�ssrY: oV f1 -T- <7 -SS ��S M•E� C'o �'. <br />P}N' M <br />TF=.WArrJE* AFT'oar[nrfXr mow. <br />(MOM a 411OW 1 d "ne" days: trod dale of +lPp)Ntatkm submlteat) <br />CNFC K r X'r0 t=XPEntM REQUEST •15100 R�UUK�iPR[%CESSED lH 7 gL)SIN@9t3,AJ►l1a <br />SIGNATURE OF -APPLICANT DATE <br />W-9 T <br />fRX AbMtfili .. , : .... ; <br />1f L <br />fj r <br />�. <br />❑ Unit 1 <br />09f Ugii.2. <br />300 <br />Unit d <br />0 Unit 5 <br />L u,-" U CTd A,/ <br />�+ r6 k14,1 <br />7 r f SUni! <br />. <br />a 9n a <br />ENVIRONMENTAL HEALTH D I <br />e.UNVkRGROUM0 TANK NI17 "W01' Sn (LUPI 4 HOUS=MG AiBi►t1�1 - ff SOL 16 *AM FAMM-, �bTHER CLEANUP-SrrE jWM-LQP) 0 FMD FAC44TY o SOLID 1d on- VENC► A <br />'Sr VKW_1tG'R0UK0TMK (M0MT0 ti OVAL) 0 DOG IKENtQEL 0 UAWY <br />00US WASTE GENERATOR 0 CtUCKEN RANCH ❑ PKG 7RLATMENT PUV ' <br />Or TiEREU PE" M TT'E'0 F'A41LITf 0 'MOTEIMOTEL Q FU MPMTRUcwrAnMHEm To&0E :S <br />0 TArroomooy Pw.RciNG 13 PooLspA o LAND USE APP tCAI12=5 <br />W MF=AL WALT' FACIL.LTY O OTHER (PLEASE SPECIM <br />ust up to ten addresses in un space above_ Select trot typa(s) of files from the list aiboye 10y chreslcing <br />the appropriate box(es). At feast one file type MUST to selected. Fax to =) Au$4-01_Mnr i! to the <br />adjmsa Indicated 4!22": <br />.2. EMD will notify the applicant if any END file& oxist_ An appointment for mvlpw will be confirmed <br />aMroxhatdty five bur ness days but no hater than ten (10) days after fectalpt of application, The files <br />will be held for a maximum of five businc3a days for review. Appointmcnims zhould be scheduled <br />accordingty. <br />3. A file that Is actively bang worked an by EHO 34off may not be imriiedlateiy av'wlable for review: A now <br />application maybe submitted when ttla t116 is avoilarble. <br />4. Any -file -not re'turnatf In the same condition ar,.Meased t+vM be roor0anized bj tHd sluff at the expense <br />ar the appWwL FutLr file -reviews by'the same applicant may requift a $$3.00 deposit prior to mvWw, <br />5. 'TENTAME appointment [Ates must be con Tned with EHD staff. <br />5. Applications rer.0vod aftar 3;00 pm will be processed the next burinest-day, <br />CONFIRMED APPOiNTMENt DATE. TIME <br />DATE CONFIRMED PHONE FAX INITfALS <br />REVIEWED YF -S No REVIEW DATE . <br />TO 39Vd <br />5EOT5EPSTP Te:9e E©0Z/TT/TT <br />