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4,:Vujq lypuLit.1c m <br /> EALTH SERVI(;L-,5 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> TKIRD FLOOm <br /> 3"DIST WEBER AVENUE <br /> STOCKTOjy CA 93202 <br /> (209)468-3420 290 <br /> PUBLIC RECORUS RELEASE APPLIGA MAY 0 5 0 <br /> j, <br /> kdPjLij�l M FN I AL HEALTH <br /> PLMANT <br /> AP7 - <br /> �F�FIV72 <br /> ADDRESS <br /> ell <br /> PHONE 2 <br /> FAr-SPAILE 3 —01{5;-L <br /> TENTATIVE'ApporNTIMEtITOATF A <br /> (Pi—e give 7 in,Liinezi/— <br /> jo�& <br /> k;HE-CKmQXT0FXP,9nrrEKLQuEsr- 3-00r-EE-MQ PR <br /> SIGNATURE OF APPLICAW <br /> DATE <br /> FlLc AUDAC!j3 1S 1 : : EONLY <br /> PROGRAM EL1!MEKT:5 SEARCH <br /> Ir <br /> 0 <br /> H LL) <br /> Ir- o C< <br /> C-L C- <br /> • <br /> ENVIRONMENTAL HEAL-Th DIVISION FILE <br /> Y 00 —8 2000 <br /> D8RGRO"D TANK MST)CIZANW,211TE(Lor) Zn ROV-5LNG ABATEMEW <br /> THER CLLANUP SITE(NON4.0p) C1 SOLID WASTE FAQUTY <br /> �JAI.MDVAI <br /> NOERGRGUN01ANK(MoffrTMNt C1 FOOD FAC11M a GO"*WASIFr VE113CLE <br /> MAZOkRDOUS WASTE!CENERAToR =1 DW AENNEL DAIRY <br /> 0 TIERED PERimmn FAci"ry 0 CJOCKEN RANCH d PXG TFTATmr!wr PLA.NT <br /> ❑ TArrGCXBQDY pEjRCjK(; 0 KuyFLA40TEL 13 PUMPER TFtUCMARDDHM yoLF <br /> ❑ &KOICAL WASTI!FACwrry 0 POOUSPA 0 LAND U*F-APPLICATION SrrU TS <br /> 0 PtLaLJC WATER SYSTEM C3 OTHER On-EASE sPEOWY A130ye) <br /> List UP to ten addre3*03 inttwspace abvve. select the type(,-;)of files from the list above by checking <br /> the aPKOPriate box(es). Al least one tilt We MUST be'calld %Lt-leccted. <br /> V_ <br /> jasr In <br /> AL allove- <br /> 7. EHowiticlotifyth&applic2ntif2nYrmME)fil0t-exi3t, An OPPOiritment for review will be confiMed <br /> approximately five bu-slne=days but oo later than ten(10)dAYs after receipt Of aPPIkAtion. Theflies <br /> will be held for a Maximum Of fly*business days 191'rOview. APPOintMents5hQuidbosa schedule <br /> accordingly. ed d <br /> A Mc t11JIt is actively being worked on by END Staff may not be immediatelY av;aibble for review. A new <br /> aPPlicati011 may be submitted when the We W avahabj4j. <br /> Any M0 not returned in the:Sarno condition m&r6leased Will be reomanized by Iz No otaff at the qxpensc <br /> of the applicant- Future file Mviews by the Same applicant May requiro, 4i to review. <br /> *TENTATIVE appoinUnent 2$78-00 deposit prior <br /> dates must be cont-med with EH a staff. <br /> Applications received after 3:00 pm will be Procca*ed the next business day. <br /> CONFIRMED APPOWTIMAENT DATE <br /> CONFIRMED TIME <br /> DATE CCWFiRmED PRONE FAX INITIALS <br /> REVIEWED YES NO <br /> 8FT REVIEW DATE <br />