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Dec 08 04 02: 37p Hanover Inc 530 342 14904 p. 2 <br /> N'71-GGYJYJ •lo•.,.xv ..... _ ENOLOO NuMOER + <br /> DAYS <br /> J ENVIRONMENTrALUHEAL.TH (VISION VIES -I 4 <br /> FLOOR <br /> DEC 8 Z004 304 EAST WEBER AVENUE,THIRD <br /> STOCKTON CA 85202 <br /> (209)488-3420 <br /> NE� <br /> bBLIC JRECORDS RELEASE APPLICATION <br /> APPLICANT 1-- na 3 1a C• y , itUSINESSIAGENCY +-} aow1�1'1YYMu* <br /> ADDRESS to?2 r'I ara,ecter S}. <br /> PHONE k'S'=y) • 312.• 1?�33FACSIMILE <br /> PHONE ' <br /> 121 a�'f O� <br /> TENTATIVE'Appp1NTMENT DATETIME <br /> ._ ays - <br /> 1I��77 (Plpee plw J fn 10 near dfrom date of appliceUon sut+mltte0 <br /> L..i CNECK BOX TO EXPEDITE REQUEST.SST.t00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> DATE <br /> SIGNATURE OF APPLICANTl�/ --- <br /> FILE ADDRESS IS SIDE EHL STAFF USE ONLY <br /> ROG ELEMENTS <br /> v <br /> 21q� E. >=i'Grnont `:+•, 5+ewk1'b•+ r u.Sf IdI.J - <br /> �ot F1. Ante.ros > <br /> sa? tS. rflbu^•F uSt V <br /> z}Iz E. Fre+nD�n} '-h kS <br /> 2�!i M;ner A%&- 457- W r <br /> 2.131:. '" Ere�•.r+m�' <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> -A <br /> d UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLD WASTE FACILITY <br /> ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> ©/OTHER CLEANUP SITE(NON-LOP) ❑ DAIRY <br /> 6/UNDERGROUND YANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ PKG TREATMENT PLANT <br /> [r HAZARDOUS WASTE GENERATOR ❑ CHICKEN RIWCH <br /> ❑ TIERED PERMITTED FACILITY O MOTELIHOTEL __ ❑ PUMPER TRUCKlYARO/CHEM TOILETS <br /> ❑ TATTOOIBODY PEIRCING ❑ POOUSPA " - ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checkin' <br /> the appropriate box(es). At least one file type MUST be selected. Fax to 1209)464-0136 or mail to the <br /> 'address indicated above. <br /> 2. FHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten (10) days after receipt of application. The files <br /> wii�be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file.that is actively being worked on by EHD staff may not be immediately available for review. Anew <br /> applivgtion may be submitted when the file is available. <br /> 4. Any fiw not returned in the same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a$87.00 deposit prior to review. <br /> S. 'TENTA'i:IVE appointment dates must be confirmed with EHD staff. <br /> B. Applicaticns received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPO110 rMENT DATE TIME <br /> DATECONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> Do a Dvmrmo <br /> . TOTRL P.01. <br />