Laserfiche WebLink
Dec 15 -0 LR*24p o ational knowledge <br />,� --� \/r`L__: �i,/I%., •�........,v1.11ruClll: HEALTH $I:01cpS <br />n' \' r I li ENVIRONMENTAL HEALTH DIVISION <br />304 EAST WEBER AVENUE, THIRD FLOOR ' <br />DEC J 2OOi STO'CKTON CA 95202 - <br />(209) 468.3420 <br />—EN <br />p FFrrrrrr^ryryryTryryry PUBLI RECQRpS RELEASE APPLICATION <br />� APPt;il(yj�(�;"Ir�S " ✓i a Q.s I .,... <br />�q Du5INESS/AGENCY ©CCV vy'�fQ(� %au1 <br />x jnponcss l 11107��CIrV,nr], .Ci <br />-PHONE <br />TCNTATIVE' APPOINTM1 N,7 DATE <br />(Plan>v UbD 1 la 10 Du.�na a. Jary Imn. J,qv TIME _ <br />xuamlUnp <br />CHECK 0of nip 2116H <br />0x TO @x PEOITE RCOUESy -$09.0 FCC E EST PROCESSED IN a BVSINCSS DAYS <br />SIGNATURE PI' AHPLICAN f _ �(/•IJW( <br />p.2 <br />DATE is o2 _ la'dk-- <br />lN,& <br />0 <br />w <br />ENVIRONMENTAL HEALTH DIVISION FILES ` <br />illf"UNOERCDOVND TANK IUST) CLEANUP 517E (LUP) O KOUSINO ADATCM F.NT ❑ <br />TNER CLCANVY SIIE (NON -LOP; SOLID <br />LIT) WASTE FACICLE <br />VNpe RGReVho inns IMO NI TORINGIREMOV/LLI Q 0 CD ENNJFACILILT ❑ SOUe lvtiTi[V[N1CLC <br />HAZARDOUS WASTC GENEMTOI1 OG NENNEL P DAIRY <br />U 11COCD PERMITTED FACILITY ❑ CHICKEN RANCII 0 PKG TREATMENT PLANT <br />O TAT T09,000y ❑ MOTELMOTEL 4 PUMPER TRUCKAARDICHCM rOILCTS <br />OOOO TtP CINC ❑ pO0U5PA 11.. <br />McC�CAI Wtiae FAt:1U7Y Q LAND USC APPLICATION <br />� OUIE0. (PLEASE SPECIFY ADO nDOVCI <br />1. List up 10 Ion addresses In (hes ace a <br />p bOvo. Salocl Iho typo(:) of tilos from the list abevo by c1locMinp <br />the approprlalc box(OS). At Ioa$(017o HIO type MUST be Solueled. Fax Io (2091464.013g or rn TII 10 II c <br />000!05: InoiCIfed above. <br />EHD will notify the applicant It any END files exist. An a <br />pVUinlrn Unt for review will be confirmed <br />JPproximaloly live business days but no IalOr than Ion (10) days atter receipt of ODDlication. Thn file; <br />will uo held for a maximum of rive business days for review, Appolnlmcnls should be seheoutod <br />acaornin0ly, <br />"J. A 410 that Ix aetivoly bcln0 worked on by EHD stall may not bo imnledlately available for rcviow. A now <br />aPPlicatfon may ba submhlOd whon Iho It la is nvallablo. <br />Any file not returned in the same condition as reloasoo will be rvor0anlsed by CHD staff it the exponsc <br />Of the appllcanl. Future file rovlews by lho SamO applicant may ragvire a S0o.o0 Vcposil prior 10 evlow. <br />�. 'TENTATIVE appolnlmont dales must bo conflrrnod with EHD staff. <br />G. APPIlcations ro4clved alW 7:00 Put will ue processed the next busInoSS day. <br />CONFIRMED APPOINTIMENT DATE TIME <br />;n, ATE CONFIRMED <br />--• PHONE FAX INITIALS <br />REVIE1V�p <br />YES NO <br />REVIEW OATS <br />