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MA`'-2-�-1995 12:04 OTOCKTON PERMIT CENTER 0 209+937+8893 P.02 <br />nAlr JvmjUlir i V tibLL 1 uIIJ-rJAU" <br />Alit POLLUTION CONTROL DISTRICT <br />4230 KIERNAN AVENUE, SUTTE 130, MODESTO, CA 95356 <br />(209) 545-7000 <br />ATTENTION:- --. _ _. ___- FILE NUMBER: ---- - <br />`I'o Be Filled E ' .e By Ap,-iicant <br />BCTSINESa NAME: mn <br />SITE ADDRESS: <br />Please Check The Appropriate Box: <br />Will any load bearing structures be removed'!` ...... . ..... I... YES[ J NO J4 <br />Will 260 linear feet or more of any building material be disturbed?.... YES[ ] NO X <br />Will 160 square feet or more of any building material be disturbed?.... YES N NO [ ] <br />will 35 cubic feet or more of any building material be disturbed?...... YES j J NO <br />For District Use Only <br />[ ] <br />The business has been identified as being exempt from the requirements of the <br />APCD. <br />[ J The business is subject to the permit requirements of the APCD. The applicant has <br />filed a complete application with the APCD. <br />[ J The business has obtained the necessary permits or authorization from the APCD. <br />[ ] The business is NOT meeting the APCD requirements. The building permit process <br />may not proceed and a Certificate of Occupancy may not be issued. <br />[ ] The applicant shall subT - >,n asbestos notification and survey to the APCD within <br />10 working days prior asbestos removal. <br />[ ] The building permit process may continue subject to the following conditions: <br />APCD APPROVAL BY: <br />(See reverse side for OES requirements) <br />DATE: <br />