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Dsn� Inc S,'5 '1 25CI P. I <br /> ENO 1-1-G N0M3=-:R <br /> su <br /> DATE RECOVED <br /> R rr""'C -�ANJOAQ,UIN COUNTY <br /> NT <br /> NVIROPMENTAL HEALTH DEPARTME <br /> 304 E Weber Ave Id HOOT SIDOKW4 CA 95205 <br /> JUL 8t29�P468-34.1.�-")F-a,,-: ('209)464-0138 rj,ca-usMNt <br /> EWRONMENT HEALTH ) 3 <br /> PUB1,19' R.L�CGRDS RFLJEi ASF, A-PPLICAJ70N <br /> APPLICANT: oi-41-t lk'wvi, f:. <br /> wi Y' 0 f W.I A 5-2-3 <br /> ADDRESS; <br /> PEONE: V FACSIMILE, ka. <br /> TENITATIVE"APPOIN74ENT DATE: 9 <br /> j T, <br /> lemm al"OV/10 husimms firoyn d-e'e of ap-Aicadc n suhr*tal) 0140P <br /> CHECK i3t.x'rn EXP-zDi.TE:4.C. FEE--RHUUEST PROCESSI-A)IF4 3 BU!ul�rwz'17AY5 <br /> f. j- <br /> SIWATURE 4 APPLICANT <br /> D F ©ATE <br /> Do-,partmerTiz Use On�, <br /> FILF ADDF.;-:7!3�; <br /> L7 U <br /> HW <br /> \"j L <br /> a. <-f- 14t,) <br /> D \� <br /> 5. Street 3#6,7 W, t- i se- A <br /> unit 3 <br /> 1 <br /> *10 <br /> 'Jn�4 doom <br /> >00� <br /> T fix <br /> rjupgPEM <br /> ENVIRONMENTAL HEALTH DEPAIRTMENT!FILEN <br /> F ;jM0ER3FR0LP0rANK(X:-T)OLEPMUPVT E(�-OFI) V HOIJ-SiNG A.9,W,'F M� Fffr M SOUD WASTE FACIUir( <br /> 0 PC.-VD 9.G11.,- M fV7VD WASTE VEHICLE <br /> Q1 �u1VDF!RGR0`.JN0 7-ANK :7 Doe T;um'E�L 0 "IA'Py <br /> 0 HAZAR,3x)L't S w&a 4"C'4;r-NCM C' corvm-K Ftvjv�' 0' PAG TREATMEXr FLP44'r <br /> M TIERED PERMM!7;FAMPY' 0 V0'TE1A40*M,1L. 13 �'PUMPER TRUCKNARDICHViVi TOILETS <br /> 0 K,101-ISPA 0 LAND USE APOUCATION SITES <br /> MEDICAL WASTS FACILITY 0 <br /> 1. List up,to ter vd6recrsets�F,:the s M. =above. Selu,-4 tPm- fg*s'i ffle-,�f—,m the ft:t above. by checking <br /> !,tie fi-A le-wit ane fillr-.:11!p?M111i.iT N::.scA�- 1efe. Fax mail to t1--1e <br /> add Ss i rild lvaivc zhova.. <br /> 2. E.HD wi;1 riotify the applicant it any EHB-t-Rcs eyj!rt, An aPPz";'kftVr'Air"[�("i7'7eview W 11 zo <br /> approx,ev'01AY.5 e±:business d"'.1ys buf no wer than tap(1-01 day:'-.aftm of vppri on. The files <br /> wif tm he?d for a rnvximurn VT five busin'kusday'?-w ravfr;-e�% shour.d. be schadul-ed <br /> accordingly. <br /> Ariew <br /> TTIaV "i"AwTiMui When Vve I]Pry if.u'av1:17kible. <br /> -Any by EFA st-11-A Idie expense <br /> &the appiicaut F%Auye F'.,e reviews by the sarvie appl*,cant may reqwrruk $93-00 trieposit prior to.evl,-*,II. <br /> EMDstaff. <br /> 6- Aunfiinafions rece-M-y'l,aftfir 3100 rim rm-NI buni. <br />