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� ` FAX NO,. 2095690295 ' Jan. 15 2003 11:53AM P2 <br /> M : Geo-Phase E InO i ronmenta l l • <br /> �r ll�//'�`I��{�y%f�'Ifl L111/1..IN{i411.1•.1. <br /> {II_�n-/\-J111. .r,—.,,li`{_ of ,fJJI 13L 1��-':1 .I; <br /> SAN JOAQUIN GOUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION ' <br /> JAN 1 5 2003 304 BAST WEB>~R AVEI�II]E,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> ENVIRui (VIEW HEAL ,9 (209)468-31420 <br /> PERMIT/SERVICESPUBLIC RECORDS RELEASE AP <br /> t-"n <br /> pL1CATlON <br /> �( r( YIG�' 8U51NE55fAGENCY <br /> APPLICANTS - - <br /> ADDRE5S 7 <br /> FAC51MILr-- �/� 5 I� x-03 q 5 <br /> Pi-iONE <br /> / TSMC <br /> TF-NTATIVE-APPOINTMENT DATI <br /> (Please givc'T to 70 pusinoss.days irol��dale of apPlicatian sul�mitlal) L4ns , <br /> VI-tHECK 13OX TO,L••XPEDITE.REQUE5T-587.00 FEE-RCQU,ES'r PROCGSSCD IN 3 j3U54N1:5S DAYS I <br /> a DATE <br /> SIGNATURE OF APPLICANT <br /> THIS SIDE EHD STAFF USE ONLY <br /> FSLC DRESS- PICOGRAM ELEMENTS 5EARCSI <br /> N <br /> -7 <br /> 106 <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> n HOUSING AESATEMENT ❑ SOLID WASTE FACILITY <br /> UNDCRGROUND YANK(UST)CLF�.NUP SITE jLOP) ❑ FOOD FACILITY O SOLID WASTE VEHICLE <br /> OTHER CLFANUP SITE(NON-LOP) ❑ DOG KENNIII. O DAIRY <br /> U!lDtrRGROUND YANK(MONITORIHGIREMOVAt} ❑ CWIC}(EN RANCH 0 PKC;TRFA'rMENT PL.ANr <br /> riPz4R000SYYAS�CENERATOR O ldOTEUIlOTEL I3 PUMPERI'RUCKIYARDIGHEM70lLET5 <br /> "❑ TIERED pERMITrl; FACILITY ❑ POOLlSPA O LAND USE RASE SPCCiFY ITES <br /> E3 TATTOOI6aDY Pi41RCING d OTFIER(ALEAS�SPCCiFYAEiOVE] <br /> 0 MEDICAL.YYAST4 FACILITY <br /> O pUElLIC WATER SYSTEM � <br /> I List up to ten addresses in the space above• Select the type.(s) of files from the list above by checking <br /> ro nate box(es). At Feast one file typC MUST bc.seiectod. Fax to 209 4G4.p'f 38 or mail to the <br /> the app p , <br /> address indicated above. intment <br /> 2. EHD will notify the appiicanIdfa s but nfiles er than ten(0) days-after for <br /> appO 1pt of applicat of n,The file$ <br /> approximately five businessy <br /> will be held for a maximurrl;of five business days for review. Appointments should be scheduled <br /> F accordingly. <br /> 3, A file that is actively being worked on by EMD staff may not be immediately available for review. Anew <br /> application may be submitted when the file is available. <br /> q, Any file not returned in the same condition as released will be reorganized by EHD staff at the expense re <br /> of the applicant. Future file roviews by the Same applicant may require a$37.00 deposit prior to view. <br /> 5, •TENTATIVE appointment dates must be confirmed with EHD staff. A <br /> S.- Applications received after 3:00 pm will be processed the next business day. qI- <br /> VEEP <br /> a <br /> 1 � <br /> �f CONFIRMED APPOINTMENT DATE' TIME <br /> y <br /> DATE CONFiRMFb PHONE FAX INITIALS <br /> NO REVIEW DATE. <br /> REVI!~WED � YES <br />