Laserfiche WebLink
DATE RECEIVED EHD I OG NUMBER <br /> r� SAN 4QUIN COUNTYPUBLIC HEALTI ERVICES � � <br /> —ENVIRONMENTAL HEALTH DIVIST: N R - MWED <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> (209) 468-3420 JUL 1 1 2002 <br /> PUBLIC RECORDS RELEASE <br /> -{APPLICATION <br /> APPLICANT CtArla-� 1`^,CAA6( f6 BUUSIINESSIAGENCY "��- InJI"�,1 X01 Pt�WJY�dI Eds <br /> ADDRESS// \ 02 Satt r/�' G$ ✓ o <br /> PHONE 1(DIDII aC� JL (A FACSIMILE <br /> TENTATIVE'APPOINTMENT DATE TIME <br /> (Please gi a to 1 b sine ays"date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST $89.00 FEE-REQUEST PROLES DIN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT . /Ili DATE 7 —Q 2 <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> L0. <br /> V l ra �r rai r. <br /> 3S1 $ <br /> LIVI , <br /> )02 <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> ❑ OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY Cl SOLID WASTE VEHICLE <br /> �Q UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑ TATTOO/aODY PEIRCING ❑ POOUSPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM OTHER(PLEASE SPECIFY ABOVE) <br /> 4�Q� - elllzr^ ��yy rtsp <br /> 1. List up to ten addresses in the space above. Select the type(s) of files from the list above by-Ichec(<ingel, <br /> the appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0138 or mail to--({he u <br /> address Indicated above. <br /> 2. EHD 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 /> 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 being worked on by EHD staff may not be immediately available for review. A new <br /> application may be submitted when the file is available. <br /> 4. Any file 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 $89.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS i <br /> REVIEWED_ YES _ NO REVIEW DATE j <br />