Laserfiche WebLink
.p 13 -04 06: 18P 1.p. I <br /> o��lai[atlo 11:ltf 45481 ENVIRONMENTAL. HEAL-.< PAGE 0I <br /> DATE 7 <br /> 7MRE <br /> SAN JOAQUM COUNTY Elio LOG fatJMaER <br /> ENVJ RONWNTAL HEALTH DEPARTMENT <br /> 2004 304 E Weber Ave 3"Floor Stockton,CA 95205 <br /> (z 09)468-3420 Fax:(209)464-0138 Web:www.co.san-joaquin-cau cb- <br /> E�vVIRO���r1r ir-S H A PUBLIC RECORDS RELEASE PPLIC,A17ON Q <br /> APPLfCJ1►fT: n�- BUSINESWAGENCY:- y >4c•-1. - ! <br /> ADORES$• r� �~ <br /> � 11` t!c•L <br /> PHONE: � C FACSRplLE' [I I f rte,{ <br /> TENTATIVE`ApPowmENT DATE: Tkno: + v 1 <br /> (Please allow 10 b,uslness d# te y&from daof appl catkm submittal) <br /> -��:CHECIC BOX TO EXP)OirE RC4UE5T- — QUES7 PROCESSED IN 3 SU51fIEr35 D <br /> SIGNATURE OF APPLICANT DATE —/ <br /> DepAMrllent l)sa anhr �• <br /> Fit..E ASS ural" <br /> '' a> It 1 <br /> sty •f4+ Chy <br /> Unit 2 <br /> 4 >DYmll J,� <br /> S• BaalCRY <br /> all <br /> r. same -Q�. ft Unit 4 <br /> Sw <br /> �• skop Unit 5 <br /> ro. wan <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES �r <br /> ODERGROUND TANK(l1s'rj MrANUP SfrE(LOP),- "rt10Us1NG ABATEMENT Q OL]D WASTE F _ <br /> THER CLEANUP SITE(NON.LOP} 13 FOOD FACR.ITY OLID WA$rEYEM <br /> O UNDERGROUND TANK(MONrfOWNGIREMOVAL) 13 DOG KENNEL ❑ DAIRY <br /> �kAZA1>!?OUS 1NASTE GENERATOR 0 CHRMEN RANCH 0 PKG TREATMENT PLAINT <br /> O T�REB PERittTTEO FACYliY <br /> 0 MOTELAiOTEL ❑ PUMpER TRu%CKMARU1CHEM TOILET <br /> 0 TATTOOIBODY PONNNG Cl POOL)SPAUSE Pilt:A <br /> 0 MMCAL WASTE FACILrIY `OTHER(PLEASE SPECIFY) f`1 <br /> 1. List up to ten addresses In the space above- Select the.type(s)Of filet,from the list above by checking <br /> the appropriate box(es). At feast one flue type fti UST be selected. Fax to f209L464-0138 or mail to e <br /> address Indicated above. <br /> 2- EHD w41 notify the applicant N any EHD files exist An appointment for review will be confirmed <br /> approMmately five business days but no later than tan(10)days after receipt of application_ The files <br /> will be held for a maximum of Five'business clays for review. Appointments should be scfledufed <br /> accordingly. <br /> 3. A file that Is actively being worked on by EHD staff may not be Irnntediately avallab(e for review. Anew <br /> application may be submitted when the file is available. <br /> 4. Any file not returned 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$93-00 deposlt is 0 <br /> 5. `TENTATIVE appointment dates frust be confirmed with EHO staff. <br /> 8. Applications received after 3:00 pm will be processed the next business day. <br /> � NIr�RMED 3►P C3�H'(fYIENTDATE =z:_ `' 7IMI E <br /> IaA''rECOftFfl2lfAf HONE FAX _ !f!1RA1.5 ;c <br /> ; . <br /> ftEWED s YES NO REVIEW DAT1=. " <br />