Laserfiche WebLink
JAN -21-03 10:41 PM OXOXOXOX0 559 325 2297 <br />.3, <br />01/21/200.3 0E: 53 46401 .. EI,14IFU4MENTAL HEAD, <br />SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br />In EE !C ENVIRONMFNTAf. HEALTH DIVISION <br />- 304 EAST WEBER AVENUE, THIRD FLOOR <br />STOCKTON CA 95202 <br />JAN 2 1 2003 (209)468-3420 <br />,',li/Ir j,�ir,,,E., , ,_ ,'. __. PUBLIC RECORDS RELEASE APPLIGATION <br />P.01 <br />PAGE 01 <br />nn)µq nulmsa <br />�r�l 333 pSt�Ll _FA11]SIMIIr saa� s <br />TENTATIVE' APPOINTMENT OAIF I - CR � -03 T1MH �+ ' � �/•� 7 <br />(Please Dlrn 7 In to huslnoss days from dalo of Pllaallan aubmlual) 1 7 <br />'SIGNATURE OF APPLICANT <br />l0. �L✓ rdvl 5 riff Z r N- (, f .A f . '3 <br />04 3 5 PACT c uH,<-) YOe-k ENTAL HE T�I�SION FILES Ln' <br />-Fi �/ e_ Stec.k'd�T73W�-' �1• , <br />YANK (UST) CLEANUP SITE (LOP) OUSING ABATCMFNT5000 WASTE FACILITY <br />OTHER CLCA14VP SITE INON•LOP) FOOD FACILITY O SOLID WASTE VEHK:Lt <br />UNOERGROUNO TANK (MONITORING/REMOVAL) M 000 KERNEL O DAIRY <br />.. HAZARDOUS WASTE GENERATOR O CHICKEN RANCH Ve PKD TREATMENT PLANT <br />TIERED PERMITTED FACILITY 0 MOT[LAIOTCL 0 POMPCn TnuOlWAm:;10HCM YonIXTV `! • <br />!UNULKGROUNU <br />TAT'OWOODY PEMCING O POOUSPA Q LAND USC APP14CATION SITES <br />MEDICAL WASTE FACILITY ,I OTHER (PLEASE SPEGaY ADOVE) <br />A SB e gYo a <br />1. List up to lust addresses In the space above. Select the typo(S) of tilos from the list above by c116911 )II. <br />the approprlaW box(es). At least one rile type MUST be solocted. Fax to (2091164,0138 or mail to the <br />address indic sled abovr.. <br />2. EHD will notify the applicant it any EHD files exist. An appointment for review will be confirmed <br />approximately five business days but no later than ton (10) days after recolpt of appiteatlon The flied , <br />will be held for a maximum of five business days for review. Appointments should be scheduled <br />accordingly, <br />3. A file that is. actively bein0 worked on by END &lair may not be Immediately available for review. An L„ <br />application may be submitted when the file is available..-. <br />4_ Any file not returned in the came condition as relened will be reorganited by EHD Staff at thk vx67a11 <br />of the applicant. Future rile roviews, by thu same applicant may require a $89.00 deposit prior to revl <br />5. 'TENTATft appointment dates must be confirmed with EHD staff,' <br />G. Applications received after 3:00 pm Will bo processed the next business da <br />CONFIRMED APPOINTMENT DATE <br />DAYS CONFIRMED <br />REVIEWED YES <br />NO <br />TIME <br />PHONE FAX INITIALS <br />REVIEW DATE �'� <br />Fa.E ADDRESS <br />'MIS SIDE END STAF USE ONLY <br />PROGItAM ELEMENTS SEARCH <br />....0 <br />. i. GCFL <br />I) <br />T —HIV <br />O0L'L.tyn <br />VNt-V rml <br />_...._ <br />Ste" t ham. <br />Tt <br />l0. �L✓ rdvl 5 riff Z r N- (, f .A f . '3 <br />04 3 5 PACT c uH,<-) YOe-k ENTAL HE T�I�SION FILES Ln' <br />-Fi �/ e_ Stec.k'd�T73W�-' �1• , <br />YANK (UST) CLEANUP SITE (LOP) OUSING ABATCMFNT5000 WASTE FACILITY <br />OTHER CLCA14VP SITE INON•LOP) FOOD FACILITY O SOLID WASTE VEHK:Lt <br />UNOERGROUNO TANK (MONITORING/REMOVAL) M 000 KERNEL O DAIRY <br />.. HAZARDOUS WASTE GENERATOR O CHICKEN RANCH Ve PKD TREATMENT PLANT <br />TIERED PERMITTED FACILITY 0 MOT[LAIOTCL 0 POMPCn TnuOlWAm:;10HCM YonIXTV `! • <br />!UNULKGROUNU <br />TAT'OWOODY PEMCING O POOUSPA Q LAND USC APP14CATION SITES <br />MEDICAL WASTE FACILITY ,I OTHER (PLEASE SPEGaY ADOVE) <br />A SB e gYo a <br />1. List up to lust addresses In the space above. Select the typo(S) of tilos from the list above by c116911 )II. <br />the approprlaW box(es). At least one rile type MUST be solocted. Fax to (2091164,0138 or mail to the <br />address indic sled abovr.. <br />2. EHD will notify the applicant it any EHD files exist. An appointment for review will be confirmed <br />approximately five business days but no later than ton (10) days after recolpt of appiteatlon The flied , <br />will be held for a maximum of five business days for review. Appointments should be scheduled <br />accordingly, <br />3. A file that is. actively bein0 worked on by END &lair may not be Immediately available for review. An L„ <br />application may be submitted when the file is available..-. <br />4_ Any file not returned in the came condition as relened will be reorganited by EHD Staff at thk vx67a11 <br />of the applicant. Future rile roviews, by thu same applicant may require a $89.00 deposit prior to revl <br />5. 'TENTATft appointment dates must be confirmed with EHD staff,' <br />G. Applications received after 3:00 pm Will bo processed the next business da <br />CONFIRMED APPOINTMENT DATE <br />DAYS CONFIRMED <br />REVIEWED YES <br />NO <br />TIME <br />PHONE FAX INITIALS <br />REVIEW DATE �'� <br />