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08/15/2005 16:09 8189790 ' JMK ENVIRONMENTF PAGE 01 <br /> IE L'='Jere roc Humm <br /> SAN JUAQUIN COUNTY <br /> LT <br /> A!Ir, 1 2005 ENVIRONMENTAL304 EAST WEBER Avg UEH LAIRD FLOOR DEPARTMENT <br /> STOCK7ON CA 95202 1135 <br /> ENVIRONMENT HEALTH (209)469-3420 <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE <br /> //APPLICATION <br /> APPLICANT C 61 13USINESSIIAGENCY_ <br /> AooRr== 036 tU-, /& r Le Son T}CY V <br /> PHONE?0 -` L � _FACSIMILEJPR// 7� 00 <br /> TENTATIVE' APPOINVENT DATE / 126ler _.- TIME ;Z_: <br /> (Ploaso give t to 10 business dar from date of application submittal) <br /> Y CHECK BOX TO EXPEDITE REQUI=ST- FE -REQUEST P CESSED IN 3 BUS114ESS DAYS p / <br /> SIGNATURE OF APPLICANT DATE ¢1 I <br /> 1`14t AODRECE THIS SID)=END STAFF USE ONLY <br /> PROGRAM ELEMENTS UEAKUH V� <br /> �a �1 522 1!A4 ,� <br /> r <br /> ENVIRONMENTAL.HF-ALT14 DIVISION FILES 4i_%_ <br /> )Ct UNDEPOROUND TANK(1151)CLEANUP SITE(LOP) D HOUSING ABATEMENT ❑ SOLID WASTE F iLrrY Y <br /> fiV OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY 0 SOLID WASTE VEHICLE <br /> XIINDERGROVNIA TANK(MONrTdRINGIRiw cvAL) 0 DOG KENNEL 0 DAIRY <br /> JWHAZAROOUS WASTE GENERATOR O CHICKEN RANUM tf PKC.TREATMeNT PLANT I <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTEL 0 PUMPER TRUCKIYAROICHEM TOILETS <br /> • TATTO01800Y PEIRCING ❑ POOLlSPA 0 I-AND USE APPLICATION Srro <br /> Ck MEUIGALWASTE FACILITY 0 OTHER(PL@ASE SPECIFY) <br /> t, List up to ten addresses in the space above. Select the type(g)of files from the list above by checking <br /> the appropriate box(Ac). At least one file type BUST be selected. Fax tQ t2091464 738 or Mail 12 the <br /> address indicated above, <br /> 2, EHO will notify the applicant If any EHD files exist. An appointment for review will be confirmed <br /> approximately fivA 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. A filo that is xctivoly being wnrkad on by EHD staff stay not be Immediately available for review. A new <br /> application may be submitted when the file is available. <br /> 4. Any file not returned in the same condition a$released will be reorganized by EHD staff at the expense <br /> of tha appticanE Future fila rr_views by the same applicant may require a$89.00 deposit prior to review. <br /> 5. "TENTATIVE appointment dates must be confirmed with EHD staff. <br /> B. Applications received after 3:00 pm will be processed the next business day. <br /> i <br /> CONFIRMED.APPOINTMENT DATE <br /> DATE CONFIRMED PHONE~ FAX fNITIALR I <br /> REVIEWED YES N0 PREVIEW 0 N'�i <br /> EH044 Roe <br /> �orl9cs <br /> ,ice_ �.. <br />