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�I� U <br /> - D SAN JOIN COUNTYPUBi IG HEALTH S CES <br /> E VIRONMENTAt_ HEALTH DIVISIO <br /> 304 EAST WEBER AVENUE,THIRD FLOOR D� <br /> JUL 0 3 2000 STOCKTON CA 95702 / I <br /> ENVIRONMENT HEALTH <br /> (209) 468.3420 <br /> PERMIT/SERVICES IPUBfLIlC RECORDS RELEASE APPLICA PON ry <br /> APPLICANT,�, V ' " `^ t3USINES3IAGF.NCY T Q. r <br /> ' <br /> ADDRESS <br /> Q (�, I <br /> PHONE f" ! 7 ,2- I FACSIMILE <br /> TENTATIVE*APPOINTMENT DATE TIME <br /> [Please pne 7 to 10 business days from date of application sobm[tlal) <br /> © CHECK Box TO EXPEDITE REQUEST- <br /> t:7&00 FEE-REQUEST PROCESSED IN]BUSINESS DAYS <br /> DATE <br /> \$IGNATRE OF APPLICANT <br /> U <br /> FILE ADDRESS f THIS SIDE EHL MFN USE ONLY <br /> PROGRAM ELE0.tENT5 SEARCH <br /> VW. Gh4rtPX laa ckron mss, a K " 1 5ZG ILI 1 <br /> Ince In 57. titan `•S 1�1� <br /> 1-l' Co 5r. 3 5 P 5Z 235f1 ZZ� au <br /> LI 51 11 3s.)-tr 1( 07 3Fsl 35 <br /> I I W. L r <br /> 515 W. Gkartw is 3 .� K f= X341 3526 <br /> Ol W . lava, odi 3���5„LL �-D a`( I 35ZG MI ENVIRONMENTAL HEALTH DIVISION FILESUS CLEANUP SITE(LOP) ❑ HOUSING ADATEMFNT O SOLI <br /> UNDERGROUND TANK( T) CI SOLID WA5TEVEHICLE <br /> ❑ OTHER CLEANUP 517E!NON-LOP) Cl FOOL)FACILITY <br /> ❑ UNnERGROUNO TANK(MONITORGlREMOVAL) ❑ DOG KENNEL 13 DAIRY <br /> IN <br /> ❑ CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> ❑ HAZARDOUS WASTE GENERATOR CI MOTEUHOTEL ❑ PUMPER 7NUCKlYARD1CHErd TOILETS <br /> En TIERED PERMITTED FACILITY 0 POOUSPA L] LAND USE APPLICATION SITES <br /> ❑ TATTOO/BODY PEIRCING O PUBLIC WATER SYSTEM CIOTHER(PLEASE SPECIFYABOVE) <br /> C: MEDICAL WASTE FACILITY <br /> 1. List up to ten addresses in the 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) 464-0138 or mail to the <br /> address indicated above. <br /> 2. EHD will notify the applicant it 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 raturned 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$78,00 deposit prior to review. <br /> S. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be•processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> ATE CONFIRMED _ PHONE FAX INITIALS <br /> L <br /> �EVIEMD YDS }Jd REVIEW DATE TOTAL P.©t <br />