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Jan 26 05 02: 58p Sacramento Office 916;4. 2222 p. 2 <br /> 02/06/2004 12:12 46401380 uwlnu. • �- -- <br /> C�U <br /> nkgR <br /> WEED SAN JOAQUIN COUNTY <br /> ENdiRONWNTAL REA]LTH DEPARTMENT <br /> "',12 6 2005 304 E Weber Ave 3"l F:oor Stockton, CA 95205 <br /> 468-3420 Fax- (209)464-0138 Web,www,eo.san-]oaquin.ca-uslchd <br /> ENVIRONMENT HFA�L�H D91 <br /> PERMIT/SERWES PU-BL IC RECORDS RELEASE APPLICATION <br /> APPLICANT: l IL I e K BUSNESSIAGENCY: KR/`t? WADDRESa: fISSoC//�7E3 <br /> C Qs�a� _ 441E c CLEGc 14A� C/9 �i 5"Z7 f� <br /> yx[ J Lf <br /> 71F/l //_�-y f1 (7(/ FACSIMILE:PHONE: / : <br /> Tons: <br /> TENTATIVE'AP <br /> >� <br /> (Please allow 10 bwlnesc days <br /> from date of aPPiieatbn*ubmlttal) E=41-,%o# <br /> CHECK BOX TO EXPE!%'trE REQUEST- REQUEST PROCESSED IN 7 BUSMESG D�AqYnS <br /> E Q <br /> SIGNATURE OF APPLICANT _ artmenl ux onN <br /> UNIT <br /> FILE ADORESS <br /> I vE GC o ❑ unit <br /> It/ ° T <br /> Unit <br /> Unit4 <br /> 0. Ai <br /> ❑ Uni15 A <br /> e. 6heM p <br /> �s ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> t' O HOUSING ABATEMENT �50LID WASTE FACILITY <br /> pERGROUNq TANK(LISW CLEANUP SITE(LOP) ❑ FODO FACILITY ❑ SOLID WASTE VEHICLE « . <br /> FUMED <br /> HER CLEANd,P$ITE(HON.LOP) ❑ 90G KENNEL ❑ DAIRY <br /> DERGROUNO TANK RaONiTORINGIREMOVW-) ❑ CHICKEN RANCH ❑ pKG 7REATIAENT PIJ�NY ! <br /> 1y, US WA iE GENERATOR ❑ MOTE�OTEL ❑ PUMP USE Ap ucARDICHEM TOtLETB <br /> �fERE0PERMMED FACILITY ❑ PoOLISPA ❑ LAND USE APPLICATON SRES <br /> aRE BODYIERCING ❑ OTHER IPLEAS6 SPECIFATTICAL WASTE VAC h <br /> List up to ten addresses in the spaeo above. Select the type($)of Was from the Uat aboveLO by Ch o III$ r <br /> f, MUST be Selected. E Y to @091464.013$or mail3q,(114 <br /> tho appropNate box(ee). At least one fila typo <br /> ddress Indicated above. intmant for review will be confirmed <br /> 2. ERD wilt rpUfy the applicant H any END fifes ezisL An aPpo atter receipt of apptu:atb^' The files <br /> approximately tivo twsiness days but no later than ten(10)days <br /> wiB bo held for a maximum of flvo business days for rovlew. Appointment$should be scluduled <br /> accordingly. y y not be immediately evatlable for review. A now <br /> 3. appllgtlon maybe submitted when Ute fI°la avaiRlabl� anized D EHO staff at the expense <br /> q Any file not returned in the same CO b the as raleae;q�tl may require a 583.60 deposit prior to review• <br /> of the applicant. Future file reviews by the same app <br /> 5 -TENTATIVE appointment dates must b be P rocassedconoed tth ehe np t business day. <br /> 6 Applications reraived alter 3:DO P <br /> TIME <br /> CONfIRM�O APPOItdTEAENT DATE PHONE . FAX' INITIALS <br /> DATE CONFIRMED REVIEW DATE <br /> REVIEWED �- <br /> YES NO <br /> ew u+x+oa <br /> wlmz <br />