Laserfiche WebLink
°Ern 1i'i i NOA ,Environmental PHONE NO. : 209 369 4228 7u-1. 11 2[103 11:05AM P2 <br /> r[_ I r j - kNo I,uc NUMBER <br /> SAN j . UIN COUNTYPUBLIC HEALTH S)t:RVICE:S <br /> ENVIRONMENTAL HEALTH D1VISK N <br /> \ ,JUN 1 .1 200j 304 EAST WEBER AVENUE,THIRD FLOOR <br /> �J STOc:KTON CA 95202 <br /> I=NVIRON110EiNT HEALTH (209)468-3420 <br /> °E(;rs1ILFRV(C E S PUBLIC RECORD.) RELEASE APPLICATION <br /> APPLICANT 11-/ BUSIMISSIAGENCY—U16A <br /> ^ <br /> ADDRESS ZZ <br /> PHONE �'-D5 �7-370/ <br /> FACSFIQILE .0`J <br /> TENTATIVE*APPOINTMENT DATE_ �` 4,/0�-3--� <br /> TIME <br /> (Pleas©give 7 to 10 bus)rto±s dysq from data of appUratl4n 3ubmitt�l) <br /> Ry CHECK BOX TO EXPEDITE REQUEST 9 FEE_ QtIESI PROCESSED IN 3 130SINESS DAY i Vn f 33 <br /> 3 <br /> SIGNATURE OF APPLICANT DATE <br /> FILE ADDRESS T7il:r 3fDE FfD STAFF USE ONLY ~� <br /> PROGRAM ELEMENTS SEARCHC� <br /> to Pro UJ4,1 3(o e 5q> c r2 — { <br /> v,v goo <br /> n L ' <br /> SC>? I)loves_ y�oL�i�.S JD 7 (�) lSon GJay 514v-1{ <br /> -VV Arco t v - r J <br /> 00 <br /> M,'.as <br /> !1L <br /> F.— <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> >�UNDERGROUND TANK(UST)CLEANUP SITE(LOP) C3HOt ISING ABATEMENT CI ;OLJC WASTE FACILITY 11.,211 <br /> 1�OTHER,CLEANUP SITE(NON-LOP) D FOOD FACILITY 11 SOLA: WASTE VI=HICLI= <br /> UNDERGROUND TANK(MON 11-ORING/R EMOVAL) ❑ DOf;KENNEL C1 vAIRI' <br /> ❑ HAZARDOUS WASTE GENERATOR O CHI:KEN RANCH Cl F1 KG I7REAT111ENT PLANT <br /> ❑ TIERED PERMn-TED FACILITY O MO"ELJHOTEL Cl PUMP 1=R TRt)CKrYARc1CHE61 TCru.ETS <br /> 0 TATTOOISODY PEIRCING D POOL/SPA 11 LAND USI'APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY O PUF LIC WATER SYSTEM C1 OTHE.1(PLEASE SPECIFY AROVI_) <br /> 1. List up to ten addresses in the space above. Selact the type(s) of file!: fro n the list abode by Chr)Cking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to 109ti 464-0138 or mail to the <br /> address indicated above. _ <br /> 2. EHD will notify the applicant if any EFID files exist. An appointment.for rp riew will be confirmed <br /> approximately five business days but no later than ten (10) days afler rec(1pt of applical;jor1. Th,!files <br /> will be held for a maximum of five businer s days for review. AppoiTltlnew s should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by FHD staff may not be Immediately available for review. A new <br /> application may be submitted when the fit is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by E:FID staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a !;89.00 deposit:prior to reviow- <br /> S. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> G. Applications received after 3:00 pm will bo processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX IN17I.1ALS <br /> REVIEWED— YES _ NO REVIEW DATE <br />