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r � � <br /> iFIE J <br /> SAN SOAQUIN COUNTY c Loc NUMBER <br /> JUL 2 0 2007 ENVIRONMENTAL$F,AJ.TkI DEFARTMNT III <br /> 600 E.Main Street, StOCkt0n,CA 95202-3029 <br /> F iVi J is N7 IEA Tiellephane: (209)468-3420 rax-(209)464.0138 Web:www.sjgov,o `/ 1/ <br /> F,FP1s1T/5ER`4I(;FS Ut <br /> PU L C CORDS RELEASE. APPLICATION <br /> APPLICANT: I U$INESSIAGENCY; <br /> ADORESa: <br /> PHONE(1); -- ^ HONE(2l: FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE: Timet 7� <br /> (Please allow 10 business days flnm date of aDO lcatlon submittal-'Tematim Only.mVat be cant rmed) <br /> ❑ <br /> CHECK ROX TO EXPFnIYF RF00 f.Q,0-FFR(r`ASH NEC ONLY)_RKOPR£T PROCUS290 IN 0 O 114=0 DAYS <br /> SIGNATURE OF APPLICANT DATE t� <br /> � w <br /> Electronic Information: ❑Llst❑'Map-Description: <br /> _ FfLE gDURESS Y ONLY <br /> straws L street Name city EWD USE,,,,—_ .._.. ._ ... <br /> z. v 00 0 unit z <br /> 3. Z � - -- - - -- - F <br /> J. '�,. T-S. k <br /> Unit 3 <br /> _._ i - - - -- <br /> 6. Una 4 <br /> Unli 5 <br /> 8. <br /> _ � n <br /> 9. � d �E�._ Unit0 <br /> 10. �j 71i G <br /> Specific Vale Range of information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT F <br /> I�ATTOOIDODY <br /> NDERGROUND TANK(USI)CLEANUP SITE(LOP) Q HOVSINO ABATEMENT $OGD WASTE FACiLmfIVEHICLE <br /> THEIR CLEANUP SITE(NON-LOP) ❑FDOo FACILITY WASTE TIRE <br /> ND@RGROUND TANK(MCNITORINGIREMOVAL) C Doo KENNN& Q DAIRY <br /> A ARDODa WASTE 09NERATOR M CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT <br /> ERED PERMITTED FACIOTY ❑MomL/NOTGL ❑PUMPER TRUCKIYARDICHBM TOILETS <br /> PIERCING 0POOLISPA ❑LAND Use APPLICATION SITE$ <br /> C MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY)__ <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR RFMFw- MONDAY-FRIDAY 8:00 AM-S:OOPM • E'XCLUDINO HOLIDAYS. <br /> 1. List up to ten addresses in the space above. Select the typo(s)of Flies from the list above by checking the Bppropriat2 <br /> box(es)- At leaf One filn typo MUST ha xalented. FAX to(2021 dttd.M3R nr mg'I in the add I dle4tod abava Addmc s <br /> ranges will not be accepted-for additional asoiatance with 1110 addresses,OOmSCI the END.Applications received after <br /> -3:00 pm will be procassed the next business day. <br /> 2. The END will notity the applicant K any END flies exist. An appointment for revieW Will be confirmed approximately ten(to) <br /> days after Toceipt Of application. The glee will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that Is actively being worked on by END staff may not be Immediately avallable for review. A new application may he <br /> submitted when tho file Is available. <br /> 4. Any file not rcturnod.In the same condlLfon as released will be reorganized by END staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$95.00 deposit prior to review. <br /> END USE ONLY <br /> FNn M. Ofl'llflkN NyN -.u. <br /> ,1 <br />