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10/05/2005 10:32 8313351503 MARGO MACKEY PAGE 01 <br /> �'' a tsJv trurvinci� «+� �u <br /> ;���; 08/27i20E3 13:31. aEg_I' tnv -Qv �•"""• <br /> SAN JoAQuIN COUNTY <br /> '�i'IAL$)vALT�3 X?EPARTME <br /> •.;. EROIYI� � CA 95205 <br /> F:;.. ve fa Storckt <br /> 30�T. �Y 0138 Web* R"w onsa; 1-J°>�in-ca-us/chd <br /> " <br /> ' 3420 fax: 209) <br /> (2 0)4¢4 <br /> rp. ' E AI'PLIC.AVI <br /> : . � PUBLIC:RECORDSItE�EAS ^ L-� 1111 1 cv-S <br /> 9UaGV�SSItiG£NOY: <br /> ApQtsCJwT ��- 1IN <br /> i $ <br /> VSs; g��� 335^ 1So3 <br /> PHONE' 0 o <br /> W <br /> Tlrtle C �� <br /> TNFN7 DATE' <br /> TENTAT� APS <br /> (pl�s4e altoyl 10 bye;nasi drys from pate of applir�tipn subma4� <br /> CtfECiS 1i0X TO EXpE�tTE.92EQU8ET-j93.9d FEE-RE130VIT Pik 00-IN eUS1NE88 0. <br /> DATE <br /> ly <br /> siGNATURE OF APPU�ANT pepar m ntuse 0) <br /> `.. UNiT <br /> to uoil <br /> or <br /> �1C� <br /> G., ttnit2 l <br /> : . <br /> �Ur+d 3 <br /> 6. Svt* <br /> - unit a � u <br /> " unit 5 <br /> s. W, 1 <br /> 10 S"e <br /> EYIRONlV4E1�AL HEAL7K DEF'ARTMI�N f FILA <br /> fl MOUe*ta ABATEMENT �'rr XID WAgtE FAcr�rtr <br /> CLt AMUP 5ij E(LOP) Sollt�WASTE VVIHICU <br /> UNUERGROVKD TAN (UST) d FOOD II s bARY <br /> OTHER *.N P st (HONA;QR) ❑ DOO�Niil=t � �TRfATMpff pLANT I�� <br /> is U14DERG�tM T. (tdONCTORtNGfREOdOVAL) 1j CH KII PJUK4 <br /> HAZARDOUS WASTE tMERATOR a MOTELIHOTV- Rt W usl! <br /> OPLICAA ON.04 To{t 9Y <br /> TIERXD PlRIYS MD 1CIi'( t7 POOUSPA mouse APPIJCATIOIt.SftHs(U�b o <br /> TAT OCIrDOQY PtERC NLG ❑ OTHER(PLEASE SpEcim <br /> :. ($( <br /> -1 MEDICAL WASTE FA k;T1 <br /> ^' above. Se14i#the t](po(s)of fitas from ttH!tfst above by cl to the <br /> 1. List up W n addressaes�in the <br /> space e46+t-0'138 or me91 to the <br /> tfic approl i7te box(es)..At least oris fiG.type MUST be ss{ected. 1, <br /> ddress f irttment for raVieW will be Confirmed <br /> Kant if any EKD tilts exist An appo of,a tiCatlon. The tiles <br /> 2. END yaalli r} .tify y� 10 da after receipt PP . <br /> approX9m eiy Sive bus(rtess da but no later Siren ton( ) ,ntmortts should be scheduled <br /> ;`.. will be ne{ for a max(mm of five bUginess days for review. Appo <br /> according Y.. worked on by EHD staff may not be immediatcly aval9dbia for review. A new <br /> 3, n tlty that s actively,betnp <br /> ' :. .. sppU"tio ..n�ibe$ubntlttQd when the file 9s available. <br /> 4- Any filen t i• Wmilld 9n.the same condition as released will be reor�tnizedn EIiD stiff at or t view. <br /> of the•p iCar+t t�rature Site reviews by the same appticard may require z�53.Ot7 de Daft prior <br /> 6. h EHD staff. <br /> +7Etv'TAT 20*111tmert dates iI be cantirtrt d(the next business day. <br /> 6. Appiicatio%roceiYed after 3:00 pm will be proses <br /> i:. TIME <br /> "= r;1 FIRMED AP RaMENT DATE <br /> �`: .. PRONE_ FAX i1�iTiALS <br /> aATt=Co1VF19�94ii~DI ,_—��i. ,..---�-- <br /> ' REV EWED YES NO <br /> REVIEIY DATE <br />