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:.'';::4252836121 AEI .CONSULTANTS v.CSF), <br /> �� <br /> �Nj� E, <br /> . SAN JOAQUIN COUNay EHD LOG NUMBEF <br /> '` <br /> E'NVIRONMENTAL HEALTH DEPART k <br /> SEP 0 9 2004 304 E Weber Ave P Floor Stockton,CA 95205 <br /> (209)468-3420 Fax: (209)464-0138 Web:yr w' w_cv_sau joaqum_mus/ehd <br /> ENVIRONMENT HEALTH <br /> PERMITISERVIGES (' PUBLIC )MCORDS RELEASE "PLZCA.ITON <br /> APPLICANT:J )� JYYIcf '- BUSiNI SSfAG5NCY:� <br /> l�bT 1�UlTCrI{�y - - <br /> ADDRESS• -^ L�1m DiO��J�-o_ �Uk, _x2YQ 1/ti�hinLA c(`e,Q CA <br /> PHONE: GLI) 2a3 Uw o FACSIMILE: -x, - —rime.. <br /> 53 10$3 01 9L1 _ <br /> 0A,0, <br /> ym,{� TEhITATIVE*APPoiKmENT DATE: E' me: ! - <br /> n <br /> eelL't�� (Please allow 10 business days from date of application submittaq <br /> . <br /> > T P & Y [�-I�Ow <br /> HECK BOX TO EXPEDITE REQU ST-$93.04 f>r1;- QUES ROCESSE IN 3 t�USINE$S>pAYS � I <br /> SIGNATURE OF APPLICANT b DATE 6' <br /> 7F Department Use Only <br /> FILE ADDRESS UNIT <br /> ,. aveet Mc.(AI <br /> 7- sne 3io 5j5 E, G c k a `` ❑ Unit 1 <br /> so-eetMgmi (2 5/�- U <br /> - a �' u5 Z 5c7 ='s <br /> TIitz <br /> }� <br /> 1. n c� fJTit-z, <br /> s" sweet 15 w N. <br /> City <br /> 'I G �' �►' Unit 3 <br /> 7.- s. 5`l ty �{, y,' . ES U[iit <br /> 8. so-rd d <br /> 9 stet <br /> aty Unit 5 <br /> 14, Sid Q <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILESA_ <br /> � s <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) X HOUSING ABATEMENT NSOLID WASTE FAC <br /> OTHER CLEANUP srrE(PION-LOP) ❑ FOOD FACILITY 0 SOLID WASTE VEN f <br /> KK UNOE:RGROUND TANK(MONTTOFUNGIREMOVAL) U DOG KENNEL O DAIRY <br /> HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH U PKG TRE:ATMtNT PLANT <br /> TIE=RED PE}21 n-17ED FACILITY ❑ AMOTELIHOTEL PUMPER TRUCKIYARVICHEM TOILETS <br /> O TATTOOlSOD7 PIERCING ❑ POOLISPA LAND USE APPLICA"ON SITES <br /> ES MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECI <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list aboye by checking\ <br /> the appropriate box(es)- At least one file type MUST be selected. Fax to(209)464-3138 or mail to,the <br /> address indicated above. , <br /> 2. EHD will notify the applicant if any EHD files eASL An appointment for review will be confirmed <br /> approximately five business days but no later than ten (10)days after receipt of application. The files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. Afile that is actively being worked on by EHD staff may not be Immediately available for review. A nem <br /> application may be submitted when the file Is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the.expen5e <br /> of the applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review <br /> S. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> s. Applications receiver[after 3:00 p'm will be processed the next business day. <br /> TIME <br /> CC)NFjRMED.APPOINTMENT DATE- - _ ,:�"' ` - �' ...a.- "�` ~ <br /> DATECONFIRMED" ::.` <br /> `I?HO[VE': - FAX- - INITFTACS':'= `.'.�.. <br /> REVIEWED YES NO REVIEW DATE <br /> erto sa"2-0os a� <br />