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03t2lb N <br /> D)ljI, I <br /> jlN COUNTYpLIBLIC HEALTH SERVICF-S <br /> SANJOAQI ENVIRONMENTAL HEALTH DIVISION <br /> FEB 6 2001 ENV 'THIRD FLOOR 304 FAST WEBER AVENUE, <br /> STOCKTON CA 95202 <br /> (2091468-3420 <br /> P <br /> pUBLIC, RECORDS RF-1-F-ASEAPPLicATION <br /> VAK <br /> APPLICANT BUSINFs5iAGENCY <br /> •-,T-P,,;!P C� Uj, e- <br /> ADDRESS <br /> PHONE FACSIMILE0, <br /> 'TENTATIVE'P�PPO'INTMEHT OAT' �ftm dats:�OfIPIpllstjon submittal) <br /> (pj&a�d.v*7u,,0bu5InQ13days 0 <br /> CHECK J&OXTQ' XPIZOITE REQUEST F FEE-REQuoS1 PROCESS ED IN 3 BUSINESS DAYS <br /> DATE <br /> SIGNATURE OF APPLICANT I. <br /> Yµ13 SIDE END STAFF US—ECN—LY <br /> FILE ADDRESS P G E EMS SEARCH <br /> 29.5 <br /> ,- <br /> 2- 01..-'Lk- + 3527 <br /> 3 0 <br /> 3 <br /> lee . ..... <br /> eILES <br /> ENTAL ALTH DIVISION F <br /> ENV RON SOLID WASTE I FACILITY <br /> �NUp ❑SITE(LOP) C, HOUSING ABATEMENT ❑a SOLID WASTE VFHICLE <br /> C FOOD FACILITY . 0 DAIRY <br /> RGROUUD TANK CUSI)CLF-' <br /> 0 OTHER CLEANUP SITE(HON-LqmlCgREMOVAL) 0 god KENNEL 0 PKG TRFATMENT PLANT <br /> 0 LINDERGROkIND TANK(MO14ITCIRIN 0 CHICKEN RANCH 0 polpF.It TRUCKIYARDICHEM TOILETS <br /> 0 HAZARDOUS wASTE GENERATOR Cl j&QTF <br /> ,j,40TrL M LAND Usj APPLICATION SITES <br /> ❑ TIERED PERMITTED FACILITY a POOIJ$PA 0 OTHER(PLEASE SPECIFY ABOVE' <br /> • TAr7C1OMO0Y FORCING 0 PUBLIC WATER SYSTEM <br /> • .1ED,CALWASTE rACILI11 <br /> files lure list above by checking <br /> 'Ssq&in the Space abOV*. Select the WOW Of �L jZtb mall to <br /> List up to ten add re x to <br /> gj 464- I-8SL---M <br /> the uporopriatia boi(as)- At <br /> least one file type MUST be Selected-, W Will be confirmed <br /> address indicated above. if any FRO IiIQS exist. <br /> An appointment for reviOV of application. The files <br /> F <br /> 2. HD Will notify the lapplicant but no later than ten(10)days after r4r9il"t <br /> approximately five�ausjM&SS days ould be Scheduled <br /> will be field for a mat business <br /> of five business days for review. AppOln"e"til Sh <br /> accordingly.actively being Worked on by EHD staff may not be immediately available for review. A new <br /> 3. A RIO that is the.RIO W available. <br /> application May besubmitted whO.r' reorganized by EHD Staff at the expense <br /> 4- MY file nol,ro%urniti In the SaIYO condition a3 released will be fee <br /> of the appilGaint. fUtVr*Site rcyjgws by the Same applicant may require a$97.00 deposit prior to review. <br /> -HD staff. <br /> 5. 'TENTATIVE appoj�iftnent dates mur <br /> .t bt with F <br /> 6. Applications received afte.r 3:00 pm will beconfirmed processed the next business day. ----------------------7. <br /> TIME <br /> CONFIRMED APPOINTMENT oATE ------- <br /> PHONE FAX INITIALS <br /> 1 PAT[CONFIRMED ---------- <br /> REVIEWED �YE�,S VIEW DATE TOTAL P-02 <br /> ........ .... ... <br />