Laserfiche WebLink
»ar .26. 2003 1 opM CONDOR F'-'ITTECHNOLOGIES <br /> s�46G Nu6Pt I <br /> rEt ca„>dnr rf F- i SAN JOAQUIN COUNTYPUBLIC HEALTM Si RNPICES � <br /> �_�� ., ,--: �AL.TH DiViSiC3N <br /> ENVIRONMENTAL H <br /> 304 EAST 1MEgER AVl~NUIv,THIRD FLO�R <br /> S zQQ3 STOCKTON CA 95202 <br /> MAR 2 <br /> . (209)46m-342! I � <br /> t-NV 0NMR4T HEALTH, pUBUC RECOPWS RELEASE APPLICATION <br /> el BuS NEMAGENCY <br /> PPLICANT---fFqHONE _ <br /> FACZMUZ <br /> �,;�� <br /> T TATIVE"AP !TMEiiT DATE�f llcaalan sub�IdfS aQ , <br /> (please$iNe 7 to 70 husu� days from dada at aPp , <br /> t <br /> kn <br /> —3 Clii~CI4 BOX TO i=XPEDFM REQUEST-$87.00 FEE— <br /> QUEST T PROCESSED IN 3 UU51NE5S DAYS <br /> DATE <br /> I' <br /> ;IGNATURE OF APPLICANT 11 If <br /> *Hl:i SIC! F-14IJ STAT I USE ONLY <br /> FILE AO»RESS pRQGRAM F_L VU- r'1"S SEARIC" <br /> �. <br /> O1" <br /> r <br /> kO i 1 <br /> �o <br /> too <br /> a lj <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> b HOUSING ABATEMENT I som wA5 fE FACILIly <br /> UNDERGRO�1H0 TANK(UST)CLEANUP Sn 7t:(LOP) o F4000 VAISOLID WASTE VEMC <br /> OTHER CLEANUP SITE(NON-Lop) ❑ DOG KEN14EL C7 pA T <br /> PLANT <br /> UNDERGROUND TANK(MONITOiiWGIR AOVAL) ❑ Pl�ib TREA7UCKI ARDIC <br /> HAZARDOUS WASTE GENERATOR ❑ NO"r LME�N RANCH li 0 PUMP7�R TR I.IYAAiilC1-fEirl TC)11�5 <br /> FACILITY ❑ MOTELlt:iOYEL <br /> 0 TIERED per i r~i LM4D USEAPPi.1CAFiON S <br /> ❑ TATTOOMODY PEiRCING ❑ PUBLIC WATER SYSTEM ❑ O7HER(PLEASE:$-PECIFY ADaVE} <br /> 0 MEDICAL.WASTE FACILITY <br /> . Select the type(s) of filra�frarxt the ii:�t.:tbave by che<:ki;ncl <br /> 1. List up to ten addresses Itt the spacea t one fille tabovype MUST be se ectad. 1=akltta:�'•C►8 --- l31 ai to - <br /> the appropriate box(es). At le t7► ., ) <br /> address indicated afaove. appointment for�viraw wil6 be confirmed <br /> 2. Fklp yviI! notify the appiiaant if any EHD files exist, An app ipt of application. The files , <br /> approximately five business clays but n4 later than tett (10) days of nkrilen should►e scheduled <br /> will be held for a maximum of five business days for review. App <br /> accordingly. staff may not be Irnm�ediatel,f availainie for review. A neinr <br /> 3. A file that is actively being worked on by EH❑ <br /> application may be submitted when the file is available. artiiz,_d la END staff at the exp.eslse <br /> 4. Any file riot returned in the same cnrldition as released I cant ma r� ire t,$37 00 deposit prior to rErvi-aw_ � <br /> of the applicant_ Future file reviews by the same app YI <br /> 5, *TENTATIVE appointment dates must be-colnfirmed with I HD staff. <br /> 6. Applications received after 3.00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DAVE TIME <br /> i, L1.1t'1"1Ns 91 <br /> n�..�n►If. CAV <br /> nd-r>=c'Mtcro��n <br /> I <br />