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FROM Geo-P#,ase Environmental ?Rte. FAX NO. : 2095690295 N-e`un. E9 200E 03:23PM P2 <br /> --�., <br /> ;-HOLOG NuMseR <br /> PATE RECEIV00 J <br /> SAN OAQUIN COUNTY <br /> W L� 1J l LTJ FN�4NMENTAL HEALTii DEPARTMENT <br /> 304 p-Weber Ave 3'd Floor Stockton,CA 95205 <br /> JUN 9 200P)%')468-3420 Fax: (209)464-01313 Web:www-Co-Sinjoaquin.ca.usfehd <br /> bq4 <br /> ENVIRONMEN i HEALTH PUBIC RECO RDS RELEASE APPLICATION -- <br /> �_ s1j51NE631AGENGY: <br /> APPLICANT: Zre - � .!/ <br /> AQDItESB: FACSIMILE: <br /> P11oNE: <br /> TEPTTATIVWAPPOINTM"TDATE; <br /> , <br /> Time: <br /> (plme allow 10 bu*iness days tram date of application submittal) <br /> CA <br /> CH>nCK BOX.TO FXPE171TE REQUEST.$V3.00 FEE-REQUEST PROCESSED 1N 3 B 1NT:SS PATS <br /> DATE <br /> SIGNATURE OF APPLICANTrtrnent Use only <br /> UNIT <br /> FILE ADDRESS <br /> t. 0' !✓ �` « �°' Unit 1 <br /> Unit 2 <br /> ei <br /> k a Unit 3 <br /> Unit 5 <br /> g, street <br /> th. 54eet <br /> ENVIRONMENTAL HEALTH DEP TMENT FILES <br /> C3 HOUSING pgATEMENT ❑. SOWDWASTE FACILtTy <br /> ZrUNDEItGROUND TANK(UST)CLEANUP SITE(LOP) D FOOD FACM Y 0 SOLID WASTE VEHICLE <br /> IOTHER CLEMuF SITE(NON-LOP) O DOG FAMI: V DAIRY <br /> �UNDERGROUNDTANI((MONITORINGIREIAOVAL) Ol CHICKEN RANCH <br /> A PKCTREATiVt1:NTPLANT <br /> 13 HAZARDOUV.WAMGENEMXOR CI MOTELIHOTEL Cy PUMpEFiTRUCKryARD1CHEM TOILETS <br /> CI TIERED PERmnTED FAC1LnY 17 POQL!&PA [3LAND USE APPLICATION SEMS <br /> 0 TATTOO150DY PIERCING 0 OTHER(PIRME SPECI <br /> 0 MEDICAL WASE FACILITY <br /> 1. List up to tart addressee in the space above. Select the type(s)of files from the lift above by checkln$ <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(209)46 0138 or r-011 to tll-3 <br /> addresS indicated above. <br /> 21 END will notify th buslne.�s days but no later th n ant if any EHD files OxIst. t n(0)days afteappointment r receipt of application.Th fife$ <br /> approximately fiveointments should be scheduled <br /> will be held for a maximum of five business days for review, App <br /> aeCordingly. END staff may not be immediately available for review, A new <br /> 3. Ante that Is actively being worked an by y <br /> application may be submitted when the file is available. EI'l13 girt(at the expense <br /> 4. Any file not returned in the sar>ze condition as released will be reorganized by <br /> of the applicant. Future file reviews by the game applicant may require a$93.00 depasi#prior#p review, <br /> 6. 'TENTATIVE appointment dates must <br /> be confirmed <br /> lth D <br /> 6. Applications received after 3:00 pm will be p <br /> • YES ..•. . .....: .,:.,'•:Eo?l�eseE d- the next business <br /> tsiness day. <br /> ..,.. TIME <br /> COdFIR-MEBD APP9, TENTDAAE <br /> DATCONFIRMD RVEW DATE- <br /> t'1"l�ri.:�' <br /> RYWD PO <br /> ~ r <br /> EHa�ea2�ne — . <br /> tuer�oo� <br />