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PAGt o' "• <br /> - TERRASEARCH PAGE9I <br /> 01/31/2000 15111 19252436 <br /> EdNIPONWNTAL Ff. 'LTH `�awarA <br /> J 12/09/200'1 i0:a0 4640138 <br /> `fCv'' A �JOAQUIN COUN?YPUBLIC HEALTFI SERVICES <br /> �� LL�i ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE-,THIRD FLOOR <br /> C 0 9 ZOOZ STOCKTON CA 9$202 <br /> � [3NMEN i f! f (209)468-3420 <br /> 1 IR <br /> r , LIC RE-00RDS RELEASE APPLICATION Y <br /> APDL CANT <br /> C�/V DUSINESSIAOENCY �'e-YV�`SP- �•y `ASC <br /> ADDRE33 �ri7 /�Y-�R�4 I�ZY//�Y . CAi '!% <br /> PHONE �91 •� `1%lam a ._FAdeMiLE '�"*'�'i .Sr7 hY _�o �y�p •I ' <br /> {�1`7.0 2 � <br /> TENTATIVE'.APPOtwmrr4T DATE TIME <br /> (Plew3o etre 7 to 10 business dors r.om dile of applluHlen oubmillall ■eft TL �� . f <br /> CHECK BOX TO EXPEDITE REQUEST-509.00 FEE-REDUE R ESSEU IN 3 BUSINESS DAYS • •' • a///Jr <br /> SIGNATURE OF APPLICANT DATE ' <br /> PILE ADDRESS THIS SIDE EMD STAFF USI ONLY <br /> PROGRAM ILEMKNTS SEARCH <br /> z - _ O <br /> r n K-vi O <br /> m <br /> N <br /> ENVIRONMENTAL HEALTH DIVISION FiLES <br /> tTA� <br /> NDERGROUND TANK Il1STl CLEANUP SRE(LDP) Q HOUSING ABA'tEMENT M SOLID WASTE FACILITY C <br /> T FR CLEANUP SITE"N•LOPI FOOD FACRRY f3 SOLID WASTE VEHICLE <br /> NERGROUNDTANK(MONTrORINGhtEhiOVAL) U DOG KENNEL ❑ DAIRY <br /> DOUSWASTEGENERATOR 0 CHICKEN RANCH O PUM TREATMENT PLANT <br /> IEPER 7D FACILrrr O MOTEUHOTEL O LAND USTRUCIVYAROINHE►I TOILE'T9ODY PEIRCIN. 0 POOUSPAO LAND USE APPLIGATlON StTE5 <br /> EDICAL W�LSTE FACDI_nY 0 PUBLIC WATER SYSTEM O OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses In the space above. Select the types) of tiles from the list above by checking <br /> the appropriate bax(es). At least one file type MUST be Selected. FOX to (209)464-0138 or mall to the <br /> .• address indicated abDve. <br /> 2. EHD will notify the applicant if any EHD tiles exist. An appointment for review will be confirmed <br /> approximately five business days but no later than tan (10)days after receipt or application. The tilos <br /> will behold for a maximum of five business days for review. Appointments should be schedUlod <br /> accordingly. <br /> 3. A file that.ls actively lAin0 worked on by EHD staff may not be Immediately available for review. A new <br /> application may be submitted when the rile is available. <br /> 4- Any file not returned ih the same condition as released will be reorganized by EHD staff at the expanse <br /> of the applicant. Future file reviews by the same applicant may require a$69.00 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 /> Post-tr Fax Nate •.7671 D'M - -Da -" I — <br /> CONFIRMED APPOINTMENT DATE 1° IAI4ILi0m m <br /> CcJDePiiE3 <br /> (oDATE CONFIRMED PHONE pis PNme• l �•REVIEWED YES NO RFsur ) 14 <br /> `OJ <br />