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al•=ei - 40 #404 P.D01 <br /> }} F�o � H zae:�si�,es H. BOLE A�OeA�""IATES 530*633+0118 04 "�•12007 16: . ^. <br /> jc 1 11 <br /> ENVIRONMENTAL HEALTH PAGE 81 <br /> SAN JOAQMN COUxff <br /> ' 2 0 0 71EMRONM.ENZ'AL HEALTH D rokRunw <br /> 304 Fast We "� <br /> ber Av�uc, 3 Floor,Stockton,CA 95202-2708 O <br /> n "elghoa=(204)468 342o Fax:(249)464-0138 Web: <br /> Wwwsjgay.orgJell <br /> `� •�'� ' � - •'j't•�` � <br /> -PUBLIC RECOR�S <br /> RELEASE A)?PLXCATTON <br /> APPLJCMiT; <br /> ADDPZM, �dC. <br /> Pf14HE(t <br /> TENTATNE'APPOIN ENT DATE: %//7 rime• <br /> (Fleece attar 10 6usinexs dam Irom��te or Rppilcafion a86n+t!!al-•tmliLSre onlX-Rsust �confins:cdl ' <br /> ` )�CHEC K BOX M OMME MOUEST-i93A FM(CASH OR CMCK ONLY)«REQUEST PNnOSED'IN 3 BUSMUS DAYS <br /> `SIGNATURE OF APPLICANT � <br /> DATE d <br /> lir pT CrSTRSBlJT10H O ilei!s O Wilt 2 • Lhdt 3 L7 unn.4 •0 Unit 6 b Ura a 0 Othtr(Nec4rofllCllisLSMt pS} <br /> FILE ADDRESS END USE ONLY <br /> spa Simi way„ <br /> 4T Y�n <br /> 9s-u ID 40 <br /> 2. <br /> -77;5? <br /> Afw <br /> 7. <br /> S. <br /> 9. <br /> 10. - � r��....�•`' fir' <br /> • msatton Rogaos1d:From <br /> oda <br /> ,specific I)nttC of Infa „ �K <br /> EwRpNMENTAI.HeALTH DEPARTMENT F J' .y <br /> 1�}lADEMi00MUNK(WT)CLEAMP WM"P) 0 Housm ASAtUEKT 0 SCUD WASTE FA6'MAYN i <br /> I rdx sx£ANW SM('RMWM n Fb00 PA== ©WAM T <br /> UMVWA0UMTANK(NI01��AQ 0 DOG KENNEL P DIA Y <br /> C11waADCiISWAS7SGFJ0Elu�1]R d <br /> CIPOTA <br /> RANDN 13 WAS=WA%MTREAftMPLANT <br /> C3 MEPED P'cRIMM FA+�lr Y t7 M 13 PUWMTRuaNf KTa%rM <br /> O TATroateaCYPCReM v PoodriPA D WmVsellv�icAlyoaSys <br /> 131dEDlrAL WAZr.FAplm nhg7ttR EACE sPEfaYI, _ _—--- i <br /> _ W&LANDCUP, POUTRECOM4At AMADLF0ORPEw MlrlfdIDAYi3o0AX-&06PK -EX=MM Ta,_ 1.. <br /> 1. List up to.ten addresses In the space above. Select the t ve(s)at tiles from the Ilst abov6 by cheelung the <br /> appropliate boxies). At least one rile type MUST be selected. FM to 209 464 38 or Mail to the ad rens <br /> Indicated above. Address ranges root not be accepted—for additional assistance with file addresses,contact <br /> the EHO.Applications received affer 3:00 pm vAll be processed the next business day. <br /> 2. The EHD will 690fy the applicant ff any EHD tiles exist An appointment for review w111 be eonfirmied a <br /> approximately ten(10)dabs alter receipt of application. 'rhe tiles will be held for a makimrrm of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that Is actively being worked on by EHD staff may not be immediately avaliable for review. A ni w <br /> application may be submitted when ft file is available. ' <br /> • '3 <br /> d. Any file Mt returned in the same condition as released Will be reorganized by EHD staff at the expense of the <br /> applicant Future Tile•reviews by the same applicant may require a$93.00 deposit prior to review. . <br /> 7 <br /> ed <br /> 041P a414=6 <br /> susyoe . <br />