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NOV-22-2004 MON 02;29 P--Twining Labs FAX NO r`59 268 7126 PAGE P. 02 <br /> 10/19/2004 14:30 2583433 FIFTH FLOOR �,' <br /> SpN0A4UIN:COUNTY <br /> (0 (� HEALTH DEPARTMENT ervoo <br /> EN <br /> V R <br /> 304 EAST WESM AVENUE;THIRD FLOOR <br /> NOT 2 2 2004 STOCKTON CA-9si6r• <br /> .(?09.1498.342.0 t5 <br /> ENVIROKI�iV-i NEA H. PUBLIC RE CORDS`REL�SEADPL{CAT{Q Trac <br /> 5 _�^ Ctt Twirir� <br /> Lek Ia0fGbrlL'S <br /> APPLICANT . O5 V�� �hLJC7� S BUSINt:sS/AGENCY <br /> ADDRESS 'Z�2.�- •'�re.5nc� S�oeet' " Fie.s n0 ��• . <br /> PHONE 5b9-26�6 --40V. FACSIMILE 559-Z IZ4P <br /> ZQM j 0-30•.AAA <br /> C � 'ZpO� mon <br /> ?, TENTATIVE'APPOINTMENT DATE DQ trate�of aaa subrnIttvQ <br /> ;Af1, (Please Qive 7 to iD b"rtess days a +� <br /> �. <br /> 0� <br /> CHICK BOX TO EXPF.DM REQUEST-a89A0 FEE REQUEST PRQC SSED IN BUSINESS DAYS . <br /> �pDATE + L� <br /> SIGNATURE OF APPLICANT �G <br /> TFc 910E IDS STAFF USE ONLY <br /> FILE ADDRESS .. ., ..:' : PROGRAM><LENIENl9 SEARCH l" <br /> 3555 V4 Namw LarLe, 77 \ <br /> 3434LJ All V <br /> w�Me1' 1`R r 1tO# <br /> mw_r La rt �'+ �' \� <br /> ( FIZZ uJ- amn�er 4He <br /> 1;z5o. LU <br /> r a <br /> 1A ki <br /> N`1ttRbNMENTAL HEALTH DtV M0N FILES <br /> . � .D.SOLIDtNASTE.FACtUTY ' <br /> UNDERGROUND TANK(UST)Cl EANUP SITE(LOP} :� 110USING ABATEMENT O SOLID WASTE VEHICLE <br /> AL <br /> OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACMI Y D DAIRY <br /> i_UNDERGROUNDTANK(M"ITOWNGMJ0A0YAL)". .':a DOGKENNEL..::.;:;';. Q PKG TREATUFNT PLANT <br /> III ')d HAZARDOUS WASTE OLNERATOR CI CHICKEN RANCH D PuMPER TRUCKIYARMCHEM TOILETS <br /> 'R TIERED PERMITrOD FACILITY a;MgmtMOTEL p LAND UST:APPLICATION SRES <br /> CI TATTOOIBODY PORCING O POOLISPA <br /> CI MEDICAL WASTE FACtUTY )Q[.07HER(PL£A9E SPECIFY)' Ct Pa Y�r <br /> 1. List up to ten addresses in the space abovQ. Select the types}at files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected: Fox to(209 8 or Tng t e <br /> 1addross indicated above, <br /> 2. EHD will notify the applicant.1f any t?HO files exist tionT=An�eppointment for revtety will be caon.'td <br /> approximately five buSlRes ,daO.but tio.later than#a6.(10)days after receipt of appiicahe tiles <br /> five business days for revlow. Appointments should bQ scheduled <br /> will.be held for a MAXIMUM of <br /> accordingly. <br /> 3. A fife that is actively being worked on by EHD staff may not be immediately available for review. Anew <br /> 1 application may be submitted why the;file is available, <br /> 4. Any isle not returned in the sante conditlo i.as:released?Kilt be reorganized by sEaff at the expense• <br /> i of the applicant. Future fife reviews by the santeappi <br /> . iCAnt.may require;$89.00 deposit prier review. <br /> S, 'TENTATIVE appointment dates must be cOnfi rated with.EHD"staff.. <br /> 6. Applications received after 3.00 pm will bo pPocessed:the paxt business day. <br /> CONFIRMED APPOINTMENT DATE {{ (� ' l3` TIME <br /> DATE CONFIRMED FAX INITIALS <br /> REVIEWED . YES ATO. <br /> RF_V.JEW DATE ' <br />