Laserfiche WebLink
lit fj <br /> M �J�l1ED SAJNJ0AQM COUN-1Y <br /> _E1\17_T-t,()1,iMENTAL HEALTH DEPARTWENT <br /> SEP 2 9 2.006 04 T-ast Weber Avenue, P Floor, Stockton4 CA 95202-2708 <br /> Telephone: (_'?'V9)468-3420 Fax, (209)464-0138 Web.- iv�yws* /ehl <br /> MARONMENT HEALTH igav-Grg <br /> PUBLIC RL'CORDS RELEASE APPLICATION <br /> PE R M IMSE RME STO <br /> BUSINESSIAGENCY: 4", <br /> SIT': 31,FI,) <br /> F <br /> PHONE PY C)17- 7156 _rAGSIMILE.• (Z-11-1 217 7 7 Z 7 <br /> 7ENTAT1VE-,AFP0MTMENT DATE: Time. <br /> iPiWMAe L;!C`,V la bus?tleza days from date of application submittal-Tentavy'v only- must be cr.Tnf1r1re.d) <br /> 500 F)EXFZ;iTE $S13.00 F7(c OP. HECK ONLY) REQUEST PROCESSED IN,-,SUSiNEa:i DA'0, <br /> SIGNATUIRF OF APPLICANT DATE 21 Loi_- <br /> J+ €! EIESTCiUiJTfQ�I 11it i Cl unit 2 C:Unit 3 13 UnIt4 0 UnR5 0 Ulnft6 -M Other(electron-k-f"Isfz-1maps) <br /> —7 <br /> F11'.E-ADDRESS <br /> .......2}oax ' <br /> et 4 `.tmet�MUme -City EHO U,;E ON f <br /> ZI606 -Tracy U._s T- <br /> ROOF - <br /> ti <br /> 5-1 <br /> 5 i 6'610T.(AA;C ST4 U_:S_1t_ <br /> 694w r Ll lucpii 9.1. 4 T <br /> r <br /> Vj <br /> ..JuAk <br /> 7 <br /> 14 1- 5TT. <br /> SperMc Dstr-R.i?%,;-R of 1.9formariicn IRaqtiested. From to <br /> EN"MONMENTAL HEALTH DEPARTMENT FiLcc,', <br /> 1LEANLjF-$11t',L QF) M HousiNG ABATE <br /> 11'Er CLIANUP SIT=(NoN.-LOP) 7J FooD FAcILFTY <br /> tNUERGROUND'TANX <br /> jM0MT0,=fl1iVRw0VAL) 0 Doe KENNEL <br /> `KP&7A1200U'i WASTE GENERATOR 0 CIVCKE"CH TRzATME',17 PLANT <br /> "iITIFV PER-MMED FAC;LrTy Ll MOTE L rKr(ARDM9EM TO�LSTs <br /> "A-.,oalpnwy RIERG;4ja IJ Pas k PLICAMN WES <br /> AL <br /> MED)C 'A'AsTE FACILITY LEA -Sr- InrIT I <br /> 4- flf� <br /> TAU AND SEF PORWT RECORCS ARE AVAILAEM:ron R-icvmw- UU U1 <br /> 1 ins <br /> up to tee ?ddremsess in the space above. Select the6 N <br /> of fil f� f in the llst above,*y the king the <br /> V Fax to 0 )464-DI38 or malt to the address <br /> al�)Prop�iate box(e%). At least one file type VUST be select �F <br /> LpliggLedabove. Address ranges will not be accepted-Tor additiarra assistaTsce with file addresses,contact <br /> fthe EHDT App"klcatlons received after 3:00 pm will be processed the next business dw <br /> 4 Tlhp Ei<',will'"notffy the Eppffcapt?f any EHD tales exist. An appointmert for review dill be confirmed <br /> �pprcrnately Wi(10)day-, after receipt of application. The files will be hold for a maximurn of five hus!ness <br /> srts ;hould be schedu 10. accordingly, <br /> actlyehy bsng "orkpo on by EI ID staff may not be immediately aviflable far Fevievi. A new <br /> p fa .gy bg SUbMIfted Wfle�"tho <br /> ti .file;!.available. <br /> 4. Any f2p,not returned in the sarne condition as released will be reorganized by EHD staff at the expense of the <br /> appli,,-ipt. Future ffle reviews by the same applicant may require a$93.00 deposit prior to revlow.' <br /> o <br /> T.1-TrTT <br />