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Dec. 8. 2005 2:28PM <br />MD � , It 7, fe, Di <br />DEL; -- 0 X005 <br />rro�llor)41a� ATH <br />v <br />Ade ced GeoEnvironmental <br />1�1 <br />No. 3195 P. 1 <br />APPLICANT: Suzanne Henderson BUSINESS/AGENCY: Advanced <br />ADDRESS: 837 Shaw Road, Stockton, CA 95215 <br />PHONE (1): 249-467-1006 1 PHONE (2): Cell: 209-712-2278 FACSIMILE: <br />EHD LOG NUMBER <br />9 <br />SAN JOAQUIN COUNTYENVI1tON1V ENTAIL HEALTH DEPARTMENT <br />304 East Weber Avenue, 3d Floor, Stockton, CA 95202-2708 <br />Telephone: (209) 468-3420 Pax. (209) 464-0138 Web: www.sjgov.org/ehd <br />TENTATIVE" APPOINTMENT DATE: Time: A 59 ) <br />(Please allow 10 basiness days from date of application submittal • -reas" a only • must be confirmed) 4-^ <br />CHECK BOX TO EXPEDITE RE W T • $93.00 FEE (WH OR WECK ONLY) - REQUEST PROCESSED IN E BU?INW DAYS <br />SIGNATURE OF APPLICANT DATE la AP 164� <br />) UNIT DISTRIBUTION ) E3 Unit 1 JrUnit 2 OFUnit 3 gMnit 4 o Unit 6 ❑ Unit 6 ® Other (eledronic/lists/maps) ) <br />speOITIC LJ2W Kange or inson°nanon Kequestea: From co <br />ENVIRONMENTAL HEALTH DEPARTMENT PILES <br />N UNDERGROUND TANK (USI) CLEANUP SITE (LOP) 17 HOUSING A9AMENT ❑ SOLID WASTE FACILnYMEHICLE <br />X OTHER CLEANUP SITE (NON -LOP) E3 FOOD FACILITY ❑ WASTE TIRE <br />M UNDERGROUND TANK (MONrrORINGJREMOVAL) Q DOG KENNEL ❑ DAIRY <br />M HAzARo= WASTE GENERATOR ❑ CHICKEN RANCH d WASTEWATER TREATMENT PLANT <br />17 TIERED PERMITTED FACILITY O MOTUMOTFL t3 PUMPER, TwxWARo/CN£M To1LETs <br />O TAT roo/BoDY PIERCING E3 POOLI$PA 10 LAND Use APPLICATION SITES <br />MEDICAL WASTE FACILITY ® OTNER (PLEASE SPECK <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILMLE FOR REVIEW MONDAY -FRIDAY 8:00 ADA -$:0011M - EXCLUDING HOLIDAYS. <br />1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checking the <br />appropriate box(es). At least one file type MUST be selected. Fax to (209)464-0138 or mail to the address <br />indicated above. Address ranges will not be accepted — for additional assistance with file addresses, contact <br />the EHD. Applications received after 3:00 pm will be processed the next business day. <br />2. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br />approximately ten (10) days after receipt of application. The files will be held for a maximum of five business <br />days for review. Appointments should be scheduled accordingly. <br />3. A file that is actively being worked on by EHD staff may 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 as released will be reorganized by EHD staff at the expense of the <br />applicant. Future file reviews by the same applicant may require a $93.00 deposit prior to review. <br />EHD 4"2-M <br />IMM <br />