Laserfiche WebLink
SAN JOAQUIN COUNTYPIL18LIC HEALTH SERVICES <br /> I]RONMENTAL HEALT4 DIVISION ATTI-2 0. �'lcv\eku— <br /> AaWO --.4 EAST WEBER AVENUE.T1 11RD FLOOR,_- <br /> f" STOCKTON CA 952:32 <br /> (2091468-3420 <br /> 12, <br /> BIC RECORDS RELFAS APPLICATION <br /> LC <br /> Wr <br /> S. <br /> APFUCA <br /> LU sf-'Cet sovlay-ngL' C�:A' 9�;,dr-7�2 C= Lu ca <br /> CD <br /> -FACSIMILE 9'r,, - (O' r0+9 C-1j -1 <br /> TENTATIVE`APPOINTMENT DATE Vir-cl, �an.-Z4 -nme lc' 00 aO'-*- <br /> LILA(pleasa give 7 to to business daysfrorn date f application submittal) <br /> c::r, <br /> 01"CHECK SOXTO EXPEO"REQUEST-$97.00 FEE-REQUEST PROCESSS)IN 3 BUSINESS DAYS U-j <br /> SIGNATURE OF APPLICANT DATE I- ZZ.—01 <br /> FILE ADDROSS TWS$I Dr;EKD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> 501 LA�+ KCAV14.Y"21k L-0919, _i-�; <br /> '-Rot West Ke*%eMr-'1r% LAV'CL-aL <br /> 4-0 k jt44�,Or <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> a,/Urq0SRGR0UNCI TANK LUST)OLZAA10 SITE(LOP) Q HOUSING ABATENIt 4T E3 SOLID WASTE FACT TY <br /> ZI OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY 0 SOUP WASTE VEHICLE <br /> • VNPERGROUND TANK(MONITORINGIREMOVAL) C1 DOG KENNEL C3 DAIRY <br /> • HAZAR13OUS WASTE GENERATOR. C2 CHICKEN RANCH C3 PKG TREATMENT PLANT <br /> C1 TIERED FERJUTTIE0 FACILITY 0 MOTEUMOTEL C3 PUMPER TWCYJYAFM1GHF-M TOLLETS <br /> 13 TATTOOISODY PEIRCiNG C3 PoOLISPA , - 0 LAND USE APPLICATION SITES <br /> M MEDICAL WASTE FACIIJTY 0 PUBLIC WATER SYS EM C OTHER(PLEASE:UPECIFYABOVE) <br /> 1. List up to ten addresses in the space above. Select the type[s) of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fpx to (209)464-01,98-pr ma-L <br /> Tp the <br /> addgnsjntllcaterl jjb2've. <br /> 2. EHO will notify the applicant if any EHD files exist. An 8ppointment for review will be confirmed <br /> approximately five business days but no later than ten 110)days after receipt Of application. The files <br /> will be 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 an by EHD staff may not be immediately available for review, A now <br /> application may be submitted when the file IS aVailabie. <br /> 4. Any file not returned in the same condition as re4ew5cd mill be reorganized by EHD staff at the expense <br /> oftine applicant. Future file reviews by the 5arneappliCantmay require a$87.00 deposit prior to review. <br /> S. *TENTATIVE appointment dates must be carifirmei;l wit EHD staff. <br /> AppljC-atians received after 3:00 pm will be processed tt ie next business day. <br /> CONFIRMED AppoiwrMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INMALS <br /> LREVIEM'D YES NO REVIEW DATE <br /> EM DO TOTRIL P.01 <br />