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11%10/2003 16:3q 46401- - ENVIRONMENTAL H PAGE 02 <br /> CENEQ , . �"� Y EHD L,pC;NUMBERn� � �� II' SANefQAQIlI1VCOT_11tii' <br /> NO Vj Q 304 E Weber Ave 3"d Floor Stookton,,CA 95205 <br /> 2 <br /> �9)468-3420 Fax: (209)464-0138 Web: wvvw.ca.san Joaquin.ca.us/ehd <br /> ENVIRONMEN t ti ALTN <br /> PERMIT/SFRI/ CEQ PUBLIC RECORDS PXLEASE,A►."PLICATTON <br /> APPLICANT: C_.c,ttRbA�a aS 9USINF$SIAGENCY:_. � < <l}✓/St/114r'y k"3 <br /> ADDRESS: b0 �a -� c'np 0la C t0/ c5}c 2D0 i l� �C�rCu��,c 1�- -F yS3`�Z. <br /> HONE:.-- !2S Z$3 6odc, }c !dam FACSIMILrE:_ <br /> TENTATIVE'AP801NTMENT DATE: I I 1 t 11 <br /> Time:�Liq:o d <br /> (Please allow 10 business days from date of appiiontion submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-S9 . EE EQUEST PROCESSED IN a BUSINESS DAYS <br /> .SIGNATURE OF APPLICANT DATE () 10 103 <br /> DeP2r rnent Usa Only <br /> FILE ADDRESS UNIT <br /> Z 0 F3 Iva aw Tvs,c <br /> z sane T$ GcJvsd L `11c fZc/ -rte✓� [3Unit 1 ( J <br /> 3. Stroll 23 111 y <br /> �. et . 1 � f L' RJ rae- ❑ U11it 2 <br /> 5. tea, Lil6 5 e_{-- ary i <br /> s. stro l tl�s G''c— 5 f r n c <br /> 7. oec I ,-51'- aty mac &nit4 <br /> a. S*Met 1_­L _Ms 'r-+ S iuF,6,, 5; r race 6"� C f r <br /> e. s+rc-i <br /> aty. ❑ Unit 5 <br /> � to, Sneer d <br /> ENVIRONMENTAL.HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOF) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> }�OTHER CLEANUP SITE(NON-LOP) In FOOD FACILITY ❑ SOUD WASTE VEHICLE <br /> UNDERGROUND TANK(MONI7oRLNG REMOVAL) 13 DOG IcEN41FL 0 tIAiRY <br /> HAZARDOUS WASTE GENERATOR G CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> ❑ Mt RED PERMTTTED FACILITY ❑ MOTEIIHOTHL 13 PUMPER TRUCK/YARDICHEM TO <br /> 0 TATTOOIBODY PIEMNG 13 FooL/sPA M LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <br /> 1. List up to ton addresses in the space above. Select the type(s)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Eax to/ 09 a64-0138 or mail to tho <br /> address jIndicated above. <br /> Z. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> appraximateiy five business days but no later than ten(10)days after recelpt 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 fUe that is actively being worked on by EHD staff may not be Emmedlatefy 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 as released will be reorganized by EHD staff at the expenso <br /> of the applicant. Future file reviews by the same applicant may require a$53,00 deposit prior to review, <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff, <br /> 6. Applications received after 3:00 pm will be processed the next business day.- . <br /> CONFIRMED APPOINTMENT DATE i I �- �� TIME .- q T- 7,I—/r 7 <br /> DATE CONFIRMED PHONE . FAX INITIALS', <br /> REVIEWED - YES NO REVIEW DATE. <br /> P6f- Law rP4q U, [ki II'A <br /> TO 39ad�i- ��-v� . CE�� �'Zt{��--� c�/Ii1l✓l�t ����,��c.�-vr�� `�c(�'��' <br /> (3S) S1NVi-inSNOO I3ti iZi9E8Z5Z6 bE LI E00Z/0L/II <br />