Laserfiche WebLink
10/04/2002' 11:12 209--579-2225 <br /> l w ! MQDESTQ RTC PAGE 01 <br /> SAN J6AQUIN COUNTYPUBL <br />� iC HEALTH SERVICE_ 5 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WESER AVENUE.THIRD FLOOR <br /> STOCKTON CA 95202 ,O <br /> ' (209)468-3420 <br /> PUBLIC RECO <br /> REL <br /> RDS <br /> j, EASE APPLICATION <br /> APPLICA[VT y e4l-f— BU5lN1=551AGt:NGY G ,j (l _ (` <br /> ADORES.' [ � p f OL�MITGC <br /> `�' ��c toafc c,4 <br /> PHONE OQ 222 <br /> 1i FACSIMILE L ZQ�1 S?Pf_,Z��55�_ <br /> TENTATIVII APPOINTMCNT DATC U '�� U2 rN <br /> (Please 9i a r to i0 business TIME !d PERMrT/SEF3V+��'++r <br /> ys Ir dale o P plicapo — Ili <br /> �7 ' <br /> CHECK BOX TO.EXPEDITE REQUEST fWo :-RTQ &FT P �SE N 7 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT <br /> DATLOC7Z <br /> j FILE ADDRESS <br /> THIS SIDE CHD STAFF USI:ONLY. <br /> a „d G:i►ceV, jr PROGRAM ELEMENTS SEARCH <br /> All <br /> ✓ r e F�r�s 6-1 Seed oti. y S <br /> B # 5.,#e Se ` ' 71353 T f <br /> ti c k ✓ <br /> � + Cee✓ S Q Tvo,c � r" � { <br /> DI <br /> Rill � <br /> 1a,ir 7v0CkiN 3`} <br /> Tr �v' vv v.If- <br /> ENVIRONMENTAL <br /> .ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND,TANK LUST)CLEANUP SITE(LOP) d HOUSING ABATEMENT d SOLID WASTE FACILITY <br /> �d OTHER CLEANUP SITE(NON-LOP) D FOOD FACILITY <br /> UNDE-RGROUND,�7ANK(MONITORINGIRCMQVALI p DOG KENNEL d SOLID WASTE VEHICLE- <br /> ❑ HAZARDOUS WASTE GENCRATOR 0 DAIRY <br /> E-1 TIERED PERMITT-D FACILITY t3 CHICKEN RANCH C] PKG TREATMENT PLANT <br /> 0 TATTO(?IBODY p iRCING d PAOTEIJHOTi:L ❑ PUMPER TRUCKIYARDICHEM TOILETS <br /> O MEDICAL WASTez FACILITY E3 P0Ot15PA © LAND USE APPLICATION SITES <br /> O PUBLIC WATER sYSTEM ❑ <br /> � OTHER(PLEASE SPECIFY ABOVE) <br /> 9 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 s selected. Falx to 209 464-0938 or mail to th <br /> addressindic:atcd bave. <br /> 2• Ell will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10) days after raceipt of application.-The files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingiy. <br /> 3• A file th,t is actively being worked on by EHD staff may not be Immediately available: for review. -A nays F <br /> application may be submitted when the file is available. <br /> 4. Any file net returned in the same Condition as released will be reorganized by EHD star€at tha expetasc <br /> of the applicant: Future file reviews by the same applicant may require a$07.00 deposit prior to review, <br /> 5. "TENTATIVE appointment datos must ba confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> f <br /> CONFIRMED APPOINTMENT DATE <br /> TIME f <br /> DATE CONFIRMED <br /> PHONE FAX INITIALS <br /> REVIEWED '` YT S <br /> H oo ,� goo NO REVIEW DATP <br />