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0 0 Page I of I <br />From: <br />Garrett Backus [EH] <br />Sent: <br />Tuesday, May 05, 200910:17 AM <br />To: <br />'csoftich@pcandf.com' <br />Subject: <br />5021 forms <br />Attachments: 5021 forms.pdf <br />Hi Chuck, <br />Please make any name and address and number corrections on the right side of these forms. Sign and date <br />under applicants signature at the bottom and return to this office. Pay a permit transfer fee of $40 for each <br />address: 3202 Hammer Lane, 1469 Hammer Lane and 1403 Country Club Blvd. This transfer fee will apply for <br />the UST permit and hazardous waste generator permit. Send the payment to the Accounting Dept at the address <br />below. <br />Contact Jeff Carruesco, of our food unit regarding the permits for sale of food and beverage. His number is 209- <br />468-3438. <br />Garrett Backus, REHS <br />San Joaquin County Environmental Health Department <br />600 E. Main Street <br />Stockton, CA 95202 <br />telephone: (209) 468-2986 <br />fax: (209) 468-3433 <br />email: gbackus@sjcehd.com <br />