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ICA i-1:inni. �o%IAU'4 .a:a ,. OtU.r,i V+LJ� . 'iU�� a ��,•Ui ✓:+.: •.uv <br />\a _ NAl�tcktiklYi:17 GlD ltx:NWutuEK <br />SAN QUIN COUNTYPUBLIC HEALTH VICES <br />ENVIRONMENTAL HEALTH DIVISION <br />304 EAST WF-13ER AVENUE, THIRD FLOOR <br />BTOCKTON CA flag / 11 <br />APPUC.1ti' T _GMad_t Z`elk--y [� ausitiv=tAt3 oy Mr --L -ey^ mak' <br />At}0I1"S 11i at(J�a:�E°� Y hGfG i� `'Crka 1�DeeaGea.+. <br />PHONI+ 9L--- 0$1 " 1-26-72 FACSIMILE Cylea <br />TENTATIVE` AppoiwTItEw oix-m ..w.. S�/ nem a y 3z` <br />(Please UNe T to 10 buil days tram dila of applic4on submittal <br />Q c tacit sox To snore <br />SiGNATURE OF APPLICANT <br />FOE w REQUrAT PROCESSED IN 3 BUSINESS DAYS <br />DATE S• /S -a- <br />ll /EN EM Mr- <br />1, list up to ten addresses in the space above. Select the type(s) of files from the list above by checking <br />the appropriate boxes). At least one file type MUS!' be selected_ Fax t2009) 4 +_6 Q ri to the <br />ad$nass indicaMg atiQVe. <br />2. JEW will notify the applk4nt if any EHO files exist. An appolntment for review Will be confirmed <br />approximately five business clays but no later than ten (10) days after recelpt of application. Tho files <br />will be held for a maximum of five business days for review. Appointments should be Scheduled <br />acCordingly. <br />3. A file that Is actively being worked an by END staff may not be imtmediatoly available for review. A new <br />applications may be submitted when the file is available. <br />4. Any file not returned In sane game condition as releasod will be reorganized by EHD staff at the expense <br />of the applicant. Future fate reviews by the *ama applicant may require a $78.00 deposit prior to review. <br />5. "TENTA"t'11i'S appuintmenit data* must be confirmed with EHQ staff. <br />6. Applications received after 3:00 pm will be processed the next business day. <br />CONFIRMED APPOINTMENT DATE TIME <br />DATE CONFIRMED PHONE FAX 1114TIALS <br />REVIEWED YES N® rarwusr-au naTt2 <br />13 01HER NUP WE (NON4-M <br />173 FOOD FACIL17Y <br />13 SOUD WASTE VENICLE <br />— ;.. '�. .:�.a / TANK ■...: •• •.C•: <br />M W0Kl!NN!L <br />Y DAIRY <br />■ HAZARDOUS WAVE r a° <br />■ GMCKEN .. <br />■ <br />E:1 TATTOGRMY PUIRCING <br />13 pOOj_mpA <br />0 LAND USE APPLICATION 511195 <br />■ MEDICAL WAnE FACIUTY <br />IM PUULIC WATER SYSTEM <br />■ aTHER (PLME SPEM AHME) <br />1, list up to ten addresses in the space above. Select the type(s) of files from the list above by checking <br />the appropriate boxes). At least one file type MUS!' be selected_ Fax t2009) 4 +_6 Q ri to the <br />ad$nass indicaMg atiQVe. <br />2. JEW will notify the applk4nt if any EHO files exist. An appolntment for review Will be confirmed <br />approximately five business clays but no later than ten (10) days after recelpt of application. Tho files <br />will be held for a maximum of five business days for review. Appointments should be Scheduled <br />acCordingly. <br />3. A file that Is actively being worked an by END staff may not be imtmediatoly available for review. A new <br />applications may be submitted when the file is available. <br />4. Any file not returned In sane game condition as releasod will be reorganized by EHD staff at the expense <br />of the applicant. Future fate reviews by the *ama applicant may require a $78.00 deposit prior to review. <br />5. "TENTA"t'11i'S appuintmenit data* must be confirmed with EHQ staff. <br />6. Applications received after 3:00 pm will be processed the next business day. <br />CONFIRMED APPOINTMENT DATE TIME <br />DATE CONFIRMED PHONE FAX 1114TIALS <br />REVIEWED YES N® rarwusr-au naTt2 <br />