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0'd 1d101 , <br /> JJJJJJ ENO LOG NUMMER <br /> SAN JOAQUIN COUNTY <br /> rE RECEIVED <br /> MENT <br /> NVW0NMENTAy jEALTn DEPCA 95205 <br /> `) 304 E Weber Ave Vd Floor Stockton,C . 952U5 <br /> �, uin.ca.erslehd <br /> x'68-3420'1'ax:(209)464-013$Web �vw'w.co.saxt joaQ <br /> NOV 2 4 200�U13LIC RECOMS RELEASE APPLICATION <br /> i <br /> -ALI tl <br /> TSS SSIAGENOr. <br /> ODREss: <br /> TOWAnW ApPONMeNT DATE: <br /> (M.,M ano w 10 bu* ms days Wom date cc aWg ton$40 <br /> T 3.00 FEE- T tro lil BUS,ts DAYS 16l CHOX sox TO EXPEMM RENES -S9 DATE- <br /> siGNATURE OF API'UGANT omaebr+er+t use.oozy <br /> 7TL <br /> g/`ppRESsdOX�Unit 3 \ <br /> s. <br /> Unit <br /> r p Unit g <br /> �. Sued <br /> ENVIRONM�1 i'AL HEALTH DEPARTNIET FILES <br /> t0 Ito ABATEMENT ❑ SOM WASTE VEICC A <br /> txsNb-rA K(UST)CLEMUP WE p-o� 0 sow wASlL 1rtHiCtE <br /> mym O UP SM(NON4.� G DOG FA NEL d [CRY <br /> UNMRaROUMTAHiK(MONtT�NGMEMOVAU G R Q PKaTCZEAINi CHEjRiblt�TS <br /> T <br /> onus WASGkNERAToit a L <br /> y►OTEUROTEL o AXV R'(RttCtClY �SI11ES <br /> C3 TAE <br /> RED PEpjAW D'FAW!"I 0 pooLIS?A d AKD USS AP'PLtCA <br /> M TAT1 WS6Dy PtEFit4G ❑ OTHER(PLEAS$fit CtFlf) <br /> t� mEDCCAI.WAM FAQ ve by chor"o <br /> s of files from the r �O- M112e <br /> �{• List up to ten addresses in the spacv above. Select the typet Fax to(2_14 138 or <br /> es. At least ane fiia type MUST be selectsd. <br /> the appropriate box( <br /> address IndlCated above. t if any I;HD rte$ext�t. An app�ntment for review v�lE�ccatio The files <br /> EHD rrtlt notify tt�o aPPlitt but no tater than ten(40)days after rvoeipt Of app <br /> 7- five business day$ tntments should be scheduled <br /> appro)dmately for review- APPA <br /> will be held for a maximum of five business days available for review. Anew <br /> &coordngly. • worked on by END staff may not be Immediately <br /> g. Mile that is actively being EHD stag at the expense <br /> application may be submitted whet►then IS Teased will be rgantxed by <br /> �• the same ap 10t nt may iequ7ire a$93Ao deposit prior tv review. <br /> Any file net returned in the same condition. <br /> of the appii+�nt. future bite reviews by ssna55 dny <br /> be cottftrn►ed with EHD sfaff. <br /> S• +'t•ENi'ATN>`appott►tmAnt dates must b' oracess�e3.th.Lrl -�--• <br /> Applications�eCelved after 3:00""" <br /> 6. Applies- 7671 <br /> .t-E Post-tr'Fax Note <br /> L.*O <br /> Pll RA To <br /> "x Yes <br /> Pnone 0 Fax N Fax�► <br /> *M*03 d I HEW D Zr:t t vOoZ-VZ-riON <br /> ZO/ZO'd <br />