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DEC-13-2004 12:53 CONDOR EARTH TECH 209 532 0773 P.01i0' <br /> r PATE R�CEI _ EHD LOG NUN <br /> SAN JOAQUIN COU= <br /> E+INVMONIV IN TAA Rte,. TH.DF-PARTmmNT <br /> DEC 1 3 2004 304 E WeberAve 3`1 Floor.Stockton, CA 95205 <br /> ENVIRuNi-, :_. <br /> (209)468- 420 Fax: (209) 464-0138 Web:�vvv.co.san- o tun.ca_us/ehd <br /> i1C.;;_i i1 <br /> ,j�fi,FS ftBLIC RECOUS RELEASE APPLICATION <br /> sM C <br /> APPLICANT: SUSIKESSIAGENCY: � <br /> ADDRESS: /�l(i <br /> PHON . � — l,� FACSIMILE .T <br /> T <br /> TENTATIVE APPoit TmExr DATE 1 .LJC'�CG►yt�f. ' lme: �'a q •w <br /> (Please allow 10 buslnaas days from data of appflwt(on aubneltta!? <br /> CHECK BOX To EXPEDITE T-$93-00 FEE--REDUF_ST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLI DATE I 1)tC--0700 <br /> Department Use Only <br /> FILE AbDRE55 n NIT <br /> I <br /> z snrtrr Unit I1 <br /> so-�r <br /> 31b lT� <br /> Cky Unit 2 <br /> s- Sucet d C2V <br /> a street P�►.>TG�re- Ab My <br /> Unit <br /> 7- strecr ON "TAM AIKFVr000 Ar <br /> Unit 4 <br /> N 3'0 vr Co. c.•ro�2 561 5 A r, �� �LIy <br /> S. weal LoN u G R,AIL(21`A-0 "'� L �3 G C c2 � Unit 5 � <br /> io- weer qr 1 <br /> ENVIRONMENTAL HEALTH DEPAkrFMENT FIDS <br /> UNDEPGROUND TANK(UST)C4EANUP SrrE(LOP) 0 HOUSING ABATEMENT SOLID WASTE F <br /> OTHER CLEANUP SITE(NON-LOP) b FOOD FAI:nM SOLID WASTE V �E11 <br /> UNDERGROUND TANK(MONrr RINGIREMOVAL) ❑ DOG KENNEL AT DAIRY <br /> HAZARDOUS WA`'TE GENERATOR a CHICKEN RANCH IU PKG TREATMENT PLANT <br /> Til=13ED PERMITTED FACILITY Q MOTEL/HOTEL t7 PUMPER TRUCKlYARDlCHEM TOILETS <br /> 0 TATroomony PIERCING O POOLJSPA )2�LAND USE APPLICATION SRES <br /> 19 MEDICAL WA.rSM FACIL try ❑ OTHER(PL.FASE SPECIFY) <br /> 1 <br /> 1. List up to ten addL-s-s in the space above_ Select the types) of files from the list aboye�y checkln(the appropriate bAt least one file type MUST be selected. pax to(209) 464-0138 or mail to theaddress Indicatede. <br /> 2. FHD will notify thepplicant if any EHD files exist An appointment for review will be confirmed <br /> approximately five Visiness days but no later than ten (10) days after receipt of application_ The tiles <br /> will be held for a maximum of five busine.-s days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that Is actively being worked on by EHD staff may not be immediately available for review. A net <br /> application may beubmitted when the file Is available. <br /> 4. Any file not returned in the ssafne condition as released wlll be reorganized by EHD staff at the expens <br /> of the applicant. Future file reviews by the same appl;cant may require a$93-00 deposit prior to reviel <br /> 5• *TENTATIVE appoin a nt dates must be Confirmed with EHD staff, rA <br /> 6. Applications received atter 3:00 pm wi;l be processed the next business day. - <br /> CONFIRMED APPOINTMQ T AAT!~ TIME A2�� <br /> _ <br /> DATE CONFIPMED PFIG FAX INTa LS'- <br /> REVIEWED .- YES NO REVIEW DATE <br /> TOTAL P.O: <br />