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19/26/2 0(a q 4640138 <br />� � \ ; I� ENVIROIJMENTAL HEALTH <br />1�,T1 �1�J; SANJonQU1r ICavivT <br />ENVIRONMENTAL MALTTi( OTR <br />Fcg d 7 2008 <br />304 East Weber Avenue, 314 Floor, Stocktorl, CA, 95202 270 <br />Telephone; (209) 468.3420 Far: (209) 464-0138 Web; www.Sjgov.or <br />�` <br />PAGE 01 <br />ov <br />BUSINESSlAGENdYc;f{EI CONSe LTAN•TS <br />PHONE (71: `j2S•114 Lji 7899�- <br />PHONE (2); FA �] <br />TENTATIVE APPOINTMENTpATTa CSIMILE: <br />(Please allow 10 business days from data Ofappllmlion submittal - ` Time. <br />TenfaSv0 onithe wr'^ inn <br />CI <br />CHECK 00)(Tp I'�cpE24) <br />b1TE REQUEST -$9100 FEE (CASH OR CHECK ONLY) .REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT <br />-- DATE � o d <br />list <br />1. l4855- Old //., /<� R( c El unit f <br />/ E. 850 E LovtsG ,4,14 wru+� <br />T 3, 'LT I E ZoaivC Aj, /—t - L ❑•unlit <br />V - Gw •ft. va- 7� �•� <br />4 2fI'j E LovrsL f4�e �= Unh3 <br />Q\\� S L4i�✓p <br />0 U a i�j <br />6. Unit 4 <br />7. <br />$" 0 Unit 5 <br />9. <br />1ti. C7 units <br />$peclfic Data Range of information Requested: From to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />MUNDERGROUN2 TANK (UST) CLEANUP SrM(LOP) ❑ HOUSIN6AyATEMENT ❑ <br />4 OTHeA CLEANUP SrrE {NbNJ.gp) ❑FOOD FAtZUTy ❑SOuo W43TE FACB,ITY/yEN:CLE <br />W 1190MRCOND TANK(MOMTORJNG/�eAt0yA4)✓ ❑POO KLNNeI ❑ WASTE TIRE <br />@ HAZARDOUS WASM GENERATOR ✓✓ <br />Cl TWFL0 P99MMO FACILITY ❑Gwit"It"ca ❑ WA"MAY1MTREATncNTPLWT' <br />C) TAT7MMQDYP1ERCINO - �PppL19pA dPuaP@RTRUCKlyAPhfCNa0.1 TaRETS <br />0 MEDICAL WASIV FAOILTTr 1 -WD USE APPUCATON SIX$ <br />0 OTHER (PLEASE SpECP-y) <br />WELL ANOSePTIC PVMTR@COROSAue AVAIIAnLEFOR REYII;W - MUNDAYFR1l4AY8:CQAWS;Cepm • EXCLUDIRGHOUDAYS. <br />i. LISt es to ten addresses In the space atrpy¢, Seleot tho types) of files from the list above by checking the appropriate <br />box(es). At least one 610 type MUST bo saleetod. F to a 464-013S or mail to the address IndiCatEd st, p <br />ranges will not be a@cepted--for addlUanal ussistanca with Tile addressor, contact the EHu. Applications receiv d dress <br />3:00 pm will be processed the next business day. <br />2- The EHD will nohfytho applicant if any E14O flies ex1sL An appOlntment for r@view will be confirmed oppro dinaf@lyten (f 0) <br />days after remlpt Of application. The files will he held fora maXlmurrl of five business days for revluw. Appointments <br />should be scheduled accordingly. <br />3. Afile that IS ACUVely being worked on by EHl3 staff may not be immediately available for review. A new application may be <br />subfnitWd when the file Is available. <br />4. Any file not returned In the same condition as released will be reorganized by EHU staff at the expense of the applicant, <br />Futuna file reviews by the same applicant may require a $95,00 deposit plforto review. - <br />rV <br />TO 3Jdd Tb8Z86LOTET ZT:ZT 80K/LO/ZO <br />