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b�rE FrGFJ"EG TN�4�1G�N'UYBEH <br /> SANENVIRCOUNTYPUBLIC HEALTH VICES <br /> ONME TAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 85202 r;p 0 7 2000 <br /> (2009)4683420 <br /> PUBLIC RECORDS RELEASE <br /> APPLJCAN �,��/��.+� y,/,��/ BUS/I�NESSIAGENCY <br /> ADDRESS 42 .Vitl r'�ll�/� -9;­2 <br /> PHONE 7D7Z�, VD /FACSIMILE <br /> TENTATIVE-APPOINTMENT DATE TME pecely <br /> (Ptease efua 7 to 10 by inoss days Com date of application submittal) <br /> CHECK BOX TO EXPEDITE R_E�QQU/UEST-S79.D0 FEE-REQUEST PROCESSED M3 BUSINESS DAYS <br /> SIGNATURE OFAPPLICA � Q� Lei DATE <br /> (� FILE ADDRESS <br /> 9 2 <br /> b 41tl, ,.. 2 a <br /> v 2.126 3al 439 9S <br /> IGIIo 2 23 0 5 Z <br /> i� 3P1eS <br /> E. <br /> v <br /> ENVIRONMENTAL HEALTH DIVISION FIL,EE$ APR 12 2060 <br /> �jUNDEROFtOUND TANK(UST)CLEANUP SITE(LOP) O HOUSING ABATEMENT }� SOLID WASTE FACILITY <br /> �D' OTHER CLEANUP SITE(NON-LOP) 13 FOOD FACILITY /E3 SOLID WASTE VEHICLE <br /> /� NOERGROUND TANK(MONITORINDIREMOVAL) O DOC KENNEL O DAIRY <br /> HAZARDOUS WASTE;GENERATOR Cl CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY 0 MOTEUHOTEL ❑ PUMPER TRUCKlYARDICHEM TOILETS <br /> O TATTOOIBODY PEIRCING O POOLISPA 0 LAND USE APPLICATION SITES <br /> D MEDICAL-WASTE FACILITY 0 PUBLIC WATER SYSTEM 13 OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses in tho space above. Select the type(s)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to (209)46A:Q138 or mail to the <br /> address Indicated above. <br /> 2. EHD wilt 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 578.00 deposit prior to review. <br /> 5. "TENTATIVE appointment dates must be confirmed with EHD staff. n <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 <br /> REVIEWED YES NO REVIEW DATE <br /> EH W �� eT/OSN/ <br /> TOTAL P.02 <br />