Laserfiche WebLink
FEB.04'2004 05:05 14152637262 Yaron and Associates <br /> • 03969 P.002/002 <br /> 11/04/2004 17;52 20.94683433 • <br /> FIFTH FLOOPEhivip 'SA4Jp QUINCOUNTY , <br /> ALTH <br /> PAGE 82 <br /> TWESER AVElieT -MNr304 HpSTOCKTON OR <br /> RD FL <br /> CA 95202 <br /> PUBLIC RE (209)468-3420 <br /> APPLICANT RECO RELEASE LIC N <br /> H f vl� APPArlo <br /> ADDRESS � BUSINESS/AGENCY G <br /> PHONE t7/✓jIG� ^( _� �U/J '( 41 1 1cIC/tl � <br /> xACSIMILE <br /> TENTATIVE"AP <br /> �.. <br /> DATE <br /> (Please <br /> E3G V,T, 10 huslnaeB <br /> TIME <br /> CHECK BCU(TO exPED da>/s from date of appy ki,24 sutntlittal) <br /> NATO <br /> REQUEST. <br /> SIGNATURE OF APPLICANT r �. � QUES OCESst D 1 3 BUSINESS <br /> DAYS <br /> St <br /> PILE ADDRESS DATE <br /> S SIDE <br /> RIOGRgM ELSTAFF 1)EMENTS NH <br /> gP RY <br /> SSC <br /> UNOERGROUND TAN ENVIRONMENTAL HEAL7 <br /> OTHER CLEANUP SITE(NON-LOP) H DIVISION FILES <br /> UNDERGROUND r, 'T SITE(LOP) rD HOUSING A84TLMENT <br /> HAYARDOUS GENERATOR '� FOOD FACILITY AS❑ DQ KENN& SSOLID W OLID WASTE FACILITY <br /> TIEREDP WASTE BATOR q <br /> rATTO ER)DYrMD P TE VEHICLE <br /> OiBODY PBIRCIN�`,ILITY ❑ CHICKEN RANCH ❑ DAIRY <br /> MEDICAL WASTE FACILITY 0 MOTEL/HOTEL PKG TREATMENT <br /> PLANT <br /> POOL/SPA PUMPER TRUC <br /> List UP to ten OTHER(PLEASE SPECIFY) E3 LAND USEAPP�ATION SI M TOILETS <br /> thea addresses in the s LICAnory sltEs <br /> ppropriate box es Pape above. Select <br /> the type(s)of files from <br /> a dress indi . ._a ( ) At(east one file type MUST be selected, Fax t <br /> El- will Holl cave. the list above b <br /> aPProxl n <br /> notify the applicant If an 0 64.01 r y checking <br /> Will ro held lY Ive burrlum s days but n files exist. Ana ail to the <br /> ye but no later than ten 0 ointment for review will be confttned <br /> file that <br /> isly, usinass days for review�a�after receipt of a <br /> A file that Is <br /> actively Appointments sh PPl'Cation, The files <br /> aPPIICation m y being worked On by EHD s ould be scheduled <br /> Any file not returned be submitted when the file i tail may not be Imrnedlately available for review. A new <br /> of In the sames available. <br /> ,7.EITATIVEaP Future file reviecondition the as released will be reor <br /> ppoinbnent dates mus!b the same applicant m 9anfze$ 9. EHD stat/at the <br /> APPlieatlons received after 3:OD a confirmed May require a $89.00 depositPense <br /> pm will be '"lith EMO staff. Prior to miaw. <br /> Processed the next business day, <br /> )RMED APPOINTMENT DATE <br /> 'ONFIRMED � 71ME <br /> VED �: PHONE <br /> YES <br /> FAX <br /> No INITIALS <br /> �� REVIEW DATE ��. <br />