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Y:l�lti�[riFJ. - i` LtOLNi�u+aen aha`��•� (+�e.� �> PA <br /> SAN JOAQUIN COUNTYPUSLIC HEALTH SERVICES pp�,—�Q I� <br /> ENVIRONMENTAL HEAL-4i DIVISION JUN - 8,2000 4 fl <br /> 304 EAST WEBER AVENUE,THIRD FLOOR Li'\I ViriC}i I <br /> STOCKTONCA95202 VI�IL-N'1A.L 1_ `�LTh' <br /> PUBLIC RECORDS 9R>rLEASEAF'PLlCATIO�d �E��'IT�SEAVICES <br /> SUSOesS1ACE40Yr �)(aLrbA 24.f$] 4XM6 4 C <br /> 7/,Z !` <br /> ADDRESS !f ��/`,S' 5(]�j <br /> PHONE^g7u&��$� FAGSCAILE fS50— _'i883 ! <br /> TENTATIVE'APPOINTMENT PATE ,6.1/G(Cxl TIME n <br /> (Piwwgivci wlO Wsine9e nays hwn aatziot appfiwtio submlDal) 4 <br /> CHECK SOX TO EXPECIPE REGi)6ST- a.0 E- EST PROCESSED 1N S 6'SINES&GAYS h ! <br /> SIGNATURE OF APPLICANT DATE <br /> IE <br /> FILE ADDRESS THIS SIDE END STAFF USF ONLY 1` <br /> PROGRAM ELEMENTS&PARCH it <br /> aISC &) �FlAte E <br /> a wt a e e <br /> 71 <br /> ( !E6 <br /> it <br /> i� <br /> I <br /> ��.`! VIRO NTAL HEALTH 01Vi81ON FILES <br /> ,X'AtQEAGXOUND-LANK(UST)CLEANUP.51-I!(LOP) C3 HOUSPIG A3ATEMENT C2 5000 WA4r6 FACaYrY �) ! <br /> C CLEANUR SrrE(NON10P) G FOOD FACILITY - U SOLID WASTE VEHICLE ,I <br /> � �ff��EERR O OW FENNEL 0 DAIRY �. I <br /> Jr{.yNDER6R0:1ND TANK(MONITORIYIG/REMOVAL} .f 1 <br /> O'HAZARDOUS WASTE 6SKERATOR M CHICKEN RANCtk D PKG TREATMENT PLANT <br /> C TIERED PERMITTED FACILITY M ULOTEL.%VX QL A PLM4PM TRDCKJYAROlCKEMTGa,ETS <br /> C TATTOOMOOYPEMCUIG B FOOLASFA O LAND USE APPLICATION SITES <br /> • MEDICAL.WASTe FACILITY 0 PUBLIC WATER SYSTEM O OTHER iPLEASE SPECIFY ABOVE) I� <br /> I. Liat up to ten$dOreSSCS in the space e60ve. Select the type(s)of files from the list above by CNCying. <br /> the appropriate box(es). At ieast one file type MUST be selected- Fax to 1209)464-0138 or mail to the f' <br /> adtlresa indic_at-dt`above- I� <br /> 2. EMO will notify the applicant if Cny EHD fileS exist. Aneppointmentfor review will be=11`117130d I <br /> approximately five Ousinass days but no later than ten(10)days after receipt of applicatwn. The riles <br /> wilt be held for a maximum of five business days for review. Appointments should be Scheduled ;! <br /> accordingly. <br /> 3. A file that Is actiivu y being workad on by EHD Staff may not Ile irunediateiy available for review. A new I <br /> application may he subtnitted when the file i9 svaiiabio. <br /> 4. Any file net returned in the same condition as released will be reorganized by E*HO;teff at the expense f1 <br /> of the applicant Future Me reviews by the same applicant may require a$76.00 deposit prior to review- <br /> 6. -TENTATIVE appoint'nent dAW*moat be confirmed with EHD staff, i <br /> SN Applications received after 3:00 pm will be processed the next business day. - f° <br /> 'I <br /> 77 a <br /> CONFIRMED APPOItiTMENT DATE TIME l <br /> I <br /> DATE CONFIRMED PHONE FAX INMA.L5 <br /> REVIEWED YES NO <br /> REVIEW DATE <br /> TOTAL_ P.91 <br /> J <br /> it 4 <br /> Td WOTP:60 000E 80 'unf £886 8£8 fi0E = 'CfJ-3NOHd slsr;jEw o.aaZ puno.i8 WOd-� <br /> !R <br />