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.{„ ,�� r � '9. �'it7=3:�ti•"; at 7as.: <br /> "ice u�� L•; �.�i�. �,, 5��..o .. �` . . �.�- ,�"' �.,r.: <br /> AT.T�N Co �* <br /> AUG - 2 2005. c�cr�ALSLA.LTRDEPARt�NT <br /> 304&A <br /> vet�u,3`d Floor,Stoadon,CA,•9$2 2-2709 <br /> ENVIRONMENT HEALIWepboue:(209)468-3420 Fwr.(209)46"68 Web:www0gov.ory%lid <br /> PERMIT/SERVICES i <br /> PUBUC EMRD13 , Art .xr. xxort ; <br /> A�'PI-tCAN1:_�`�� W• ��1(� �> N'E$SIA�dE�'tGY• �W1r4I� Q V 1:�Nft' �1.� . <br /> aDI�REss: x.121 N • C � r-O�N�� glv�, 5�.�� ��5 w�,a�� C � 5''t�(, <br /> PHONE ft Q S�- R 344 Plf m m._ hrlA M_5 43 q^b311 <br /> TMTATrvW APPOWME 'DATA CrAs r Tk= Ct: oa ,K. <br /> (Please afbw 10 twsinM d x from date of spOka6lon eubmfslal-"Twt ft or ly•must be conn m m <br /> E3 .00 PM( NOR d�tt.Y7—RMUMS1 P ED'IN 31 t>A,Y3 <br /> SIGNATURE OF APPLICANT W• -- Ll i DATE <br /> i i <br /> [iwr btSTRtt3t1TION <br /> 0"I q Unft 2 TWN3 90KN 4 •O Untt 6 VnK ci G CttW <br /> (a Val <br /> FME ADDRESS i �USS ONLY 5 <br /> Sheets • sthetmw" W1, I <br /> r_2 <br /> �v$l- �o - 4 I i <br /> 7. BMW <br /> I <br /> ' Specific Date Range of InfomLagan Requested:Fran+ , to <br /> P"ROMMENTAL HEALTH DEF., ENT F(LF.S <br /> otMaTAW(elsrlVLFart,%(Cop) QNmmWABATeHt3tT GtJvtin4LSmE <br /> CIF. "SIZE(NW W p) a FW0 FACaM o WASTE ThW <br /> UnpBR�ioVNo TAW(MQ DORS MOM p D,aKv <br /> WASTE MMATOR - MRCH a v1�/ISTLMYAT1� TfWA1�A W PWL4 <br /> Tla:eD Pewnw PACLITY o��IOTETPA . A P 7tia�cac/YARdK:L1Err ToK <br /> O 7 unodf3otaY p tow 0 PCQLJSPA O M t i La USEA�+�nou&M <br /> $ <br /> MLAro SO-=Pet W RiCQ ARE AVARAMe FOR RMN- &R*0 -FR'=&t 5100 Aus:WK - Doe t)n i6-M=Y@... <br /> 1. Ust up to tett addresses In the space above. Select U*tYPKs;of fifes front Jie Irist above by checking the <br /> appropriate box(es), At least one fie type MUST be selected. Fax to(209)4b4-0128 or mai[to Chep address <br /> trtdit ated above, Address tinges will not be accepted—form ditiona(assl#ance with fie�t fe=es,contact <br /> the EHD.Applications receWed after 3:00 pm wia be processes the next business day. <br /> 2. the EHD will notify the applicant 9 any EtW file$exist. An apIp�otrttment for review will be confmned <br /> approAmately ten(10)day$after r'eoeipt of application. The fL�es wtUbe held for a tnaxlm, of five business <br /> days for review. Appouthhents should be scheduled aroorTi"u' ly. <br /> 3. A file that Is actively being worked on by BW staff maty not b4immediately vau[able for fe Iiew. A obw <br /> application may be submttted when the fife Is available. <br /> 4. Any fife not returned In the same condition as released W, be��rganked k�y EHd sftft atkhe*Wnso Of the <br /> applicant Future file reviews by tate same appTimat fray reg2p a$93.00 depash.prior to iivlei w. , <br /> a <br /> �ffiN•oZ•orc � . <br /> �vzlRt ' <br /> .• I 1I i � <br />