Laserfiche WebLink
04/07/2003 17:11 92528:: ''1 AEI CONSULTANTS )F> PAGE 217. <br /> 04/07/ ' x' ENVIROWENTAL 1-.:,`_TH PAGE '�►11� <br /> pq drw�f I r L !I EMP LOG NUNRER <br /> SARI JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> APR 0 8 2003 DIVISIONENVIRONMENTAL HEALTH <br /> 304 EAST WEBER AVENUE,THW FLOOR <br /> STOCKTON CA SS202 <br /> ENVIRONMENT HEALTH 209)4EI8-3420 0 I. Fnl <br /> PERMIT/SERVI ELIC RECORDS RELEASE APPLICATION <br /> �-r� ���I'���r-��`�IJ�UJ <br /> k <br /> PLICANT INnn SUSINEMAGENCY __ APR 0 8 2003 <br /> DRESS 27 {ran -- nl� �� ,�b',tr" HEALTH <br /> ONE �1���?$3 D,��^' _- nFACSIMILE q'� Z��"L� _ PERM ERVICES <br /> TENTATIVE*APPOINTMENTDATE �4 Ig1d J -nur- - <br /> ), <br /> (Please give T to 1 b iness days from date of appl 0860,n SUL'Mir:t"al) jobr) <br /> c f� <br /> CHECK BOX TO EXPEDITE REQUEST-$89.00�FEE-RE VEST PROCESSED IN 3 BUSINESS DA'r^a � 0 <br /> SIGNATURE OF APPLICANT DATE t __ <br /> FILE ADDRESS THIS S1DE EHD STAFF LISE ONLY —-� <br /> PROGRAIII ELEMENT.SEARCH <br /> loot o S A)o <br /> � ND <br /> ._- <br /> >,J <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT C3 SOLID WASTE;FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILM 0 SOLID WASTE;W.HICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) O DOG KENNEL E) DAIRY <br /> O HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH t7 PKG TREATMENT PLANT <br /> G TIEREDPERM!' EDFACILITY ❑ IAOTEUHOTEL d PUMPERTRUPKIYARDICHE1111 TOILE73 <br /> ❑ TATTOOl60DY pE1RC1NG <br /> O POOVSPA EJ LAND USE APPLICATION WYES <br /> O MEDICAL WASTE FACILITY O I 1 11 INC3 OTHl_R(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above. Select the type(s)of files fram the list above by checking <br /> the appropriate box(as). At least one file type MUST be selected. Fax to f209 4E&)138 or mail to the <br /> address Indicated above. <br /> 2. EHD will notify the applicaltt 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 receipt of.ab13lication• The film: <br /> will be held for a maximum of five business days for review. Appointmellts should be scheduled <br /> arcgrdingly, <br /> 3. A fie that is actively being worked on by EHD staff may not be immediately available for review. A nev <br /> application may be submitted whon the file is available. EF{p staff at the ex�firlsF <br /> 4, Any file not returned In the same condition as released am Iba reorganized by 00 deposit:prior to rev€evc <br /> of the applicant. Future file reviews by the same applicant y req Po P <br /> 5. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next buslne."�S day. -_ <br /> CONFIRMED APPOINTMENT DATE TIME Post-It"Pz�Nate 7671 <br /> DATE CONFIRMED PHONE FAX I cu'v r. <br /> Phone 9 <br /> REVIEWED YES NO REVIEWDAtE ,_,.,_� --_ <br />