Laserfiche WebLink
_f TO <br /> PAGE 01 <br /> ENVIROt-Z ENTAL HEAD enu Lw NUMPMR <br /> 0 }Lr�,04 _14:50 4640138 <br /> R IcEt Ar=� V L�� SANJOAQ'tINCOUNrY <br /> >A <br /> Et�a�NTA'HEALTH D RAA 95205 7c <br /> MAY 11 2004 304 E Weber Ave 3 3 floor StocktoODS�C o9$�0„c�us/ehd <br /> ENVIRONMEra4 At(j 3h OFax•(209)`640138Web:�`v' <br /> PERMIT/SERVICES PUBLIC RECOOS RELEASE APPLICA'T'ION <br /> r7 Go <br /> Q T.c <br /> C,_u l7ik�in4� �susiNEssAGENGY; 5 /K C- IV, <br /> APPLJW- <br /> • )) ADDRESS: 3� �07i fACSIMII.E: O- �I Io-G00 66 <br /> LPHONE' f C P [�P ✓I Time: O•0�a. <br /> TENTATNE'`APPOINTMENTDA E: <br /> from dete of apPfipUon submltla0 <br /> (please allow 70 business days <br /> EST C� (� <br /> CHECK BOX 70 EXPEOrtE REOUfST•`+95-b01'EE-RPROCESSED IN 3 BUSINESS DAYSDATE ✓- l- ` df <br /> Depenem Use only <br /> SIGNATURE OF APPLICANT <br /> _ <br /> UNIT <br /> n 1 <br /> W l 5" Unit <br /> unit 3 <br /> r, sure,a creel a <br /> 1 S f o <br /> e, se�el <br /> Unit 5 <br /> ,o. succi DEPARTMENT FILES <br /> ENVIRONMENTAL HEALTH p SOLID WASTE FACILITY <br /> ❑ HOUSING ARATEME14T p SOLID WASTE VEHICLE _ <br /> UNDERGROUND TANK( T)ry,-Ep11UP SITE(LOP) Q FOOD FACILITY Q PA9V <br /> OTHER CL90UP SITE(PIONLOp) d DDG KENNEL ❑ PKG TREATMENT PLANT <br /> UNDERGROUND TANK(MONITORING MOVAL) Q CHICKEN RANCH Q P PSRTRUCKIYARDICHW TORETS <br /> d- HAZARDOUS WASTE GENEPATOR Q MOTELRIOTEL d IN7p USE APPLICATION SRES <br /> i Q TIERED PERMITTED FArKM -Q poouspA SPECiP'n <br /> L] TATrOOMODY PIERCING p OTHER(PLEASE by checl"ng <br /> Q MEDICAL WASTE FACIL.IiY Select the type(s)of files from th 4t64-0138vo mail to the <br /> List up to ten addresses In the space above'a MUST be selected. Fax to 209 <br /> i' appropriate boxes). At(east one file typ <br /> the apP P ointment for review will be confirmed <br /> address indicated above. EHD files exist. ) appointment <br /> raceipt of application. The files <br /> EHD will notify the applicant if any 10 days <br /> 2 approxll notify <br /> ointments should be scheduled <br /> Five business days but no later than ten( ) <br /> Will be held for a Maximum of five businessda for review. <br /> bmmediatery available for review. Anew <br /> acaordin9)y worked en by EHD staff may n <br /> g. A file that is aay bey being deposit prior to review• <br /> Anyfil <br /> application may be submitted when the filo is available• require a$93.00 dep P <br /> Any file not returned in the same condition as released will be reorganized by EHD staff at the exile <br /> 4. <br /> applicant- Future file reviews by the same applicant may req <br /> of the app' ointment dates must be confirmed with EHD t b - <br /> g 'TENTATNE apP Processed the next business day. <br /> 6 Applications received all"3:00 Pm will be <br /> TIME <br /> CONFIRMED APPOINTMENT DATE INITIALS �— <br /> PHONE FAX <br /> DATE CONFIRMED REVIFw DATE <br /> N6 <br /> REVIEWED YES <br /> FHP as.ccae5. <br /> R,. 50099L90E5 544T 400Z/TT/50 <br /> 0/T0 39dd Jilvo ON Snivals <br />