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01/15/04 THU 12:46 FAX P )S2029 SHAW E & I goo <br /> EWIRpNMENTAL <br /> HEO h PAGE 02 <br /> •�...._.. <br /> •0:/15/2004 10:38 4640138 Gnu wv <br /> DATE RECEiVED SAN <br /> JOAQUIN <br /> RECD[ ``f ISD E oN o>�CA p <br /> 304 B Weber Ave 3 F1 www to.san Joaquin-ca us/ehd <br /> JAN 1 5 2W69)4683420 FAX:(209)464-0138 Web: <br /> HEALTH PUBLIC 12�C0" g�LUASE�ppI,I�Ax'IO�T <br /> ENVIRONMENTPUB <br /> APPUCMM <br /> c5PRBPF' M ri A2rc5 BUSINES�AGENCYt S �C rd C� C1(4!59,0 <br /> 005 a"k � <br /> gpDRESS: ppCg{Mtl E= <br /> }ZONE• a a gg ZZg3 .�me. <br /> TENTATM!APPOINMpNj DAiE: \ A <br /> as �j <br /> (Plee a{14W 10 busias.4s�irom date <br /> of appii�iOn subtnillal) <br /> REQUEST PRC"SSED iN 3 BUSINESS DAYS <br /> EDrM RF- TQU -SM-00 FEE- DATE / <br /> Q CHECK gOX 74 EXP aftnmt Use only <br /> IGNATURE OF APPIJCANT UNIT <br /> FlLE ADORFSS <br /> EDF�I1 a <br /> s�� Q�c,,t GKmp Unit 2 <br /> 2 sae <br /> 3 3 a Ma K tan S <br /> sum t�n�n p C] Unit 3 <br /> A. G C7 Unit 4 <br /> S. <br /> Unit 5 <br /> T. Slreel <br /> 8. SYee <br /> s. street u <br /> 10• s TH DEPARTMENT FILES <br /> FwRONMENTAL Ham' SOLID WASTE FACILiTY <br /> a 140U!SING ABATEWEt4T ❑ Soup WASTF vEtH1CI.E <br /> UNDERGROUND TANK CLFJWUP SRE(1.Of') 13 FOOD FACRM a DAIRY <br /> SITE(NON*LOP1 13 DOCS KENNEi. 0 PKG TREATIIIENT Ply <br /> 0 OTHER CLEANUPpN{TpRiNGIREIAOV/►Ll p t p PUMPER TRUCKiYARDICIAM TOILE <br /> 0 �S WASTE GENERATOR O MOTE010TM O 1,/WD USE App�CAT10N SiTEs <br /> pA <br /> D TIERED t�iW>�D PACILITY p OTHER?LEASES oheCtctn <br /> G neREITATro)MODY PIERCE m the list above by q1 0�e <br /> O MEDicN-WAST`pAc►Li>Y Select the type(>;1 of files fro 4 138 or <br /> to ten addresses in the space type jAUgT be selected. ax to 30 <br /> 1. List up ate box(��• At least one file htpe iew Will be confinlWO <br /> the approp� e. An appointment for rev llcation. The file <br /> ad�tees l dlcate .,rr nt if any EtID files��• n 10 days afW r�iPt of app <br /> EMO will notify the bupl"c Qintrnents should be scheduled <br /> 2' approximately sines days but no later than review. APP <br /> app rtable for review. A n <br /> will be held for a maximum of eve business staff may not be immediately a� <br /> accordingly. a being warKed on by Hp staff at the ezper <br /> 3. A file that is activ ly when the fife is available. antxed by E staff <br /> riot to PO' <br /> e reOl <br /> application may be submitted applicant may require a$93•oo depositP <br /> Ile not returned In the same <br /> Condition e Mme app d wilt bD staff. <br /> 4. Any f re fife reviews y meed with EH <br /> of the applicant Future must be corfi 1 <br /> •TENTATIVE appointment dates m rocessed the next business day.' . <br /> 5. Applications received after 3:00 pm will be p <br /> 6. TIME <br /> CONFIRMED APPOINTMENT DATE INITIAL$ ---•"" <br /> PHONE. FAX <br /> DATE OONFIRMED NO REVIEW DATE' <br /> REVIEWED YES <br /> AND <br /> StIM03 <br />