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From:MARCUS H. BOLE AND AS'—IATFS 530+633+0119 04,"-/2007 16:40 #404 P.001 <br /> �01.18f2005a.14.01'57.i 4640132 ENVIRONMENTAL HEALTH PAGE 01 <br /> = i <br /> SAN JO,A.QUIN COYThTITX <br /> IENVMONMENTAL HEALTH DEPAR'T'MENT <br /> (Q5o <br /> 304 cast Veber Avei►uc,3'Floor,Stockton,CA 93202-2708 <br /> _: , xdephone;(20)468-3420 Rax:(209)464-0138 Web:wwwsjgov.or8 eh <br /> L PUBLIC TtECOS RELEASE EASE APPLICATION <br /> APPUCANT: BusINESS►a0EN0Y• <br /> -2 . <br /> PHONE j1 <br /> TENTATIVE'APPOINTMENT DATE �///7 <br /> (Please&now 10 bu8lness days from dAe of AponcaUon submN21-•renfaCre wdy-must be eonlirtned) <br /> ` CHECK BOX TO EXPEWE PRWEST-03.00 PM(CASHOR CitECIC ONLY) ftFQUES7Pf�OC893ED-IN a Bl1SINESS DAys <br /> ' .SIGNATURE OF APPLICANT DATE • ii o <br /> UNrrtxsTRtauhom C7 UnitS 0 Unit2 LWt3 O Urdt•4 •O UnHd t3 UnB6 C OdW(eWbVdCAWs/mipt) <br /> FILE ADDRESS EF(p USE ONLY <br /> Strew!6 street Name crq <br /> 1. O a <br /> 2. <br /> 3- c a ¢ho <br /> b. • <br /> 7. w ' <br /> 9. AN— <br /> _ <br /> "Spec Gate go of Infoonation Regaosfed:From /9OD <br /> ENVIRONMENTAL HEALTH DEPARTMENT MMES <br /> ft=QWMT' (NQpNP SrE oP) � N � �F�:TWR CMMW SM(N N4.o ) a AAM IUMXA0R0= <br /> TNM(taor��Ay fl Dae Kamm P V=V <br /> d N+vutooits w c ,Toa d CWW RANCH 6 WASTEWAM T"AtMWT PLAW <br /> O TORM P6RLq=FACUTY t7 d PUWMTMX=WNmfCHWTo(t.ETS <br /> dTni � P001.f5Pil O W1D•U6E APPUCGroSM Q <br /> D14fc7t(PtEA6E SPEd�Flfl <br /> WUL AHD szP; PEAL=PX00 Ds ME AVAtLAsLE FM P&VM-CROHDAY-Fiftnt C-00 An�o4ra -Exalxim HoLmm..~ <br /> I LtSt up to.ten addresses In the space above. Select the types)of ides from the list abovo'by oheeNN the <br /> appropriate boxtes). At(east one fife typo MUST be selected. aX to(20914G41-0138 or mai(to the address ' <br /> Indicated above. Address ranges will not be accepted-for additional assistance With file addresses,contact <br /> the EHO.Applications recehred affer 3.o0 pm will be processed the next business day. '. <br /> 2. The END will notify the applicant If any END files exist. An appointment for review will be confirmed <br /> approximately ten(10)days after receipt of application. The files will be held for a maxlmurn of five business <br /> days for review, Appointments should be scheduled accordingly. <br /> 3. A file that Is actively being worked on by END staff may not be Immediately avallaible for review. A clew <br /> application may be submitted when the file is available, <br /> d. Any rile that returned in the same condition as released will be reorganized by EHD staff at the expense of the <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit.prior to review. . <br /> J.F� <br /> END 4.02-0m <br /> tt12]I04 <br />