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Apr • y • ZUUJ 3 ZZFM WNIJUK LAKIh ILUHNULU6IL5 <br /> DATE RECEIVFJ7I L11 11SANEA <br /> _ JOUIN COUNTYPUBLtC HEALTH SAICES <br /> ENVIR3U4 EAOTNMENTAL WEH R Al/iw3�E�LTHIR DIVISIONTH FLOOR . <br />{ RPR 0 9 2003 STOCKTON CA 95202 <br /> (209)468.3420il <br /> [MIRONMENT HEAa BLIC RECORDS RELEASE Ar, PLICATION <br /> FF V1 I I Con," - <br /> j <br /> APPLICANT � (Y 617' es <br /> sustNSIAGENCY � T7f C� ,v_dID - <br /> ADDRESS^Jt3l� �5�...n gL-A'�.r. ... T-- (A q�S-2v� <br /> 3 g <br />� <br /> PHONE • O� $ FACSEJI+pLE Z3- ��' .w. - 1!0,0 'S 3 <br /> TENTATIVER APPOwT>l+IENT DATE �03 - - 1I,n <br /> (Please give T to-t business days from state of app[14i tion siibinit(nl) <br /> . CHVCK BOX TO F�EDfTir REQUEST-3 .00 F�--REQUEST PROCESSED IN 3 BVSINEHS DAYS <br /> SIGNATURE OF APPL,IC "` _ DATE 1 <br /> =ADDRESS ;, THIS:SiO�CHD STAI'll IJSE ONLY <br /> j PROIGRAM Fj.0AEKMSEARCH <br /> 3U3z 5. cL po 1 5 <br /> V I <br /> I D 11 ZF Liz) . <br /> �� �- N2. �afig•Ec I <br /> 7 <br /> 3 S.� - - <br /> Rt <br /> Gdi .a.�....�._ <br /> it �` <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> *,UN[X!ftGROUND TANK(U"CLEANUP SITE(LOP) 0 I{OU.SING ABATP.IUIEx� 1 .SOlJD WASTE F,4��Lr>r Y <br /> OTHERCLEANUP SITE(NON-LOP) <br /> FOOD FACILITY If Ell SOLID VIIAS7E'JIEISCLE , <br /> �}.ttNAE1tGROUNO TANK{11AONITOFz11VGlREiYIQYAL) C3 VC*KENNEL CII DAIRY <br /> 1� HA7ARuous WASTE GENERATOR e7 CHICKEN RANCH ;' O! pKE�T1�ATI�F�f-PLANT <br /> f� <br /> TIERED PI3iMrrTE13 FAGILrTY C7 MOTELNOTEL' ❑ PIjpEAI:;Et IRIICIC�YARi7lCNEM Ta1LET.'s <br /> 13TATr00IRODY PEIRCWG C3PO0L 3PA i ❑, LAND USE APPLICATION Sn ES <br /> ❑ MEMICAL WAST~FACILITY ❑ PUBLIC WATER SYSTEM i 0! OTpIEjr(PLEASE SPECIFY ABOVE) <br /> il c eckin <br /> above b C1'n <br /> 1. List up to ten addresses in the space above. Select the type(sI) of fifes moria the Il.I ar Y <br /> the appropriate wx(es).. At least one File type MUST be selec#ed. a t 209 464:]138 or mail to the_ <br /> address fndlcated � <br /> 2. EHD will notify the appll=nt if any EHO files exist. An appointment for review will Ile Confirmed <br /> approximately five business days but no later than ten (10)days after receipt of application. The filer <br /> will be held for a maximum of five business bays for review. Appointlrlei7t;h shaUlci be scheduled <br /> accordingly. <br /> 3. A file thaiactively being worked on by F-111) staffmay not be immedlataiy available far rlrvieVv, 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 re0rganizetd by El"1I3staff at the expen.ie <br /> of he applicant. Future file reviews by the same applicant tray requira a $17.00 deposit prior to revlobW. <br /> 5. "TENTATIVE appointment dates must be confirmed with F,I�iD staff, I <br /> S. Applications recelved after 3:00 pm will be processed the next>�ttsiness flay. <br /> I� <br /> CONFIRMED APPOINTI44ENT DATE T1ME:� <br /> 3 <br /> DATE CONFIRMS PHONE FAX -INITIALS <br />