Laserfiche WebLink
_10415/2005 16: 55 FAX ., [a 002/002 .., <br /> DATE RECEIVED /�j�(� S'AN JOAQUIN C oUNTY <br /> IR C�C�NEDD ENVM()NMENTALHEALTHDEPARTMENT ao <br /> � <br /> 304 E Weber Ave 3`d Floor Stockton, CA 95205 (' <br /> NOV 1 6 !AVA) 468-3420 Fax: (209) 464-0138 Web:'M`�•G0•S='7OW a-M1LS/ehd <br /> ENVIRONMENT HEALTH PUBLIC RECORDS RELEASE AYPLICA.'I'1b <br /> PERMIT/SERVICES <br /> O A/` ir7 17�� BUS1NEs5lAGENCY: <br /> APPLICANT: <br /> ADDRESS: <br /> �� <br /> t,( � FACSIMILE: <br /> 1 <br /> •'L 's ' <br /> TENTATIVE'AP(aINTMFSI•I DATE: Time: <br /> (Pleasa allow 7a business days from data of applicwan suhmitta6 <br /> CHECK BOX TO EXPEDITE REQUEST 59:.00 FEE—REQUEST PROCESSED IN:BUSINESS DAYS <br /> DATE <br /> SIGNATURE OF APPLICANT peoannici<Use 01* <br /> UNIT <br /> FILE ADDRESS <br /> I'1-7 Unit 1 <br /> � F <br /> o <br /> Do 10 Z G- F. Unit z <br /> +. c' Unit <br /> ver no N F U <br /> a� , F <br /> I Z L' rU l ❑ Unit 5 <br /> w, samIn <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 54,SQUO WASTE FACILITY <br /> UNDERGROUND TANK(UST)CLEANUP SrM(LOP, Q HOUSING ABATEMENT ❑ SOLD WASTE VEHIGLE <br /> QN-LOP) ❑ FQOD FACILITY E-DAIRY <br /> OTHER CLEANUP SITE(N ❑ DOG KENNEL <br /> UNDERGROUND TANK pAGNITORINC+IREMOVALj ❑ CHICKEN RANCH III- TREATMENT PLANT <br /> a0 HAZARDOUS WASTE GENERATOR ❑ MOTELIHOTEL ❑ PUMPER TRUCK/YARDICHEM TOILETS <br /> 0 TIERED PERMnTEO FACILITY ❑ POOLSPA aL LAND USE APPLICATION Sri <br /> ❑ TAT'rooiSODY PIERCING ❑ QTNER(PLEASE SPECIFr) <br /> In MEDICAL WAST£FACILITY <br /> List up to ten addresses in the space above, select the type(s) <br /> of files from the list 136 o by checking <br /> 1. a MUST be selected. Fax to 209 46A-0138 or m_ a� it <br /> the appropriate to the <br /> box(es)- At least one file type <br /> address indicated above. ointment For review will be confirmed <br /> 2- EHD will notify the applicant if any EHD files exist An appointment y p FC-ation. The Files <br /> approximately rive business days but no later than ten 10 da s after racei [ of app <br /> will he held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. Ane <br /> application may he submitted when the File is available. at the <br /> Any file not returned in the same condition as released will be reargu ned by require a$93.EHdeposff prior a en <br /> 4. orthe applicant. Future file reviews by the same applicant may req <br /> S. 'TENTATIVEappointment dates must be confirmed with EHD staff. <br /> g. Applications received after 3:00 pm wilt he processed the next business day. <br /> -,TIME .— <br /> .GbNE,�RMEQAi?.P�IPffM�NT�,ATE iSr -}: .`sr::• •r,NF19E : PHONE <br /> PATE. �?. 9fA REVIEW DATE <br /> REVIEWED YES KO <br />