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"SEP.25.200211;12:46PIlOEi4a.-AP(-ADIS GERAGHTY&HILLER/JSP(FC.RalENTAL HP-LTH NO.277 P. 1/1, 02 <br /> wre RFcov® <br /> SAN JDAQUI COUNTYPU13UC HF-ALTH 'TEPVICE <br /> NMENTAL HEALTH DIVISION - <br /> �bl C"too <br /> s <br /> t WEBER AVENUE,T'HI R STOCKTON CA 95202 - (�J f�7( l <br /> ( )4G8-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION 2 52002 <br /> APPLICANT rTO 06, v05 C. � BUSIHI=sS1Ac>I=NCY S111MMULUT HFAITH <br /> A0DRE$$ o d iu, PERMIT/SERVICES <br /> PHONE � �� 2.3 -3?�� FACSIMILE $70 2�4 3 r Z o <br /> 7 ` ` . <br /> 'TENTATIVE`.APpOtM'MtlNT HATE d Tl>ME <br /> (Plsese 91 *710 t1 mesa / t.e! Ilcetlon submittal) <br /> t Cf1CG)C BO�NrO t �Di REQUEST- -?QMUESTRO &CD 1 3 0U51NEW DAYS _ <br /> SIGNATURE OF APPLICAN DATE <br /> FILE ADDRESS TH15 SIDE"D STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> d l� <br /> OU ll U Li <br /> ✓2 t� ,� L, <br /> U <br /> Aim M*NPWM <br /> 1, <br /> 5 It <br /> t� <br /> �_4, NOA q-.2ti-02.. <br /> NVIRONMENTAL HEALTH DIVISION FILES <br /> SWDLRGROUND TANK(UST)CLEANUP SITE(LOP) D HOUSING ABATEMENT C3 SOLID WASTE FACILITY <br /> THER CLEANUP SrM(NON-LOP) M POOP FACILITY Q SOLID WASTE VENICLt <br /> UNDERGROUND TANK(MONrl"ORINGMEMOVAL) 0 DOQ KENNEL 0 DAIRY <br /> 13 HAZARAOUS WASTE GENERATOR ❑ CHICKEN RANCH C] PKO TREATMENT PLANT <br /> I] TIERED PERMt7TF,D FACILITY O MOTtUHOTEL 0 PUMPER 7RUCK/YARVICHEM TOLLETS <br /> CI TATTOO)RODY PE.tRClNQ A PODUSPA O LAND USE APPLICATION SrMS <br /> b MEDIM WASTE FACILITY C1 PUBLIC WATER SYSTEM Q OTHEFti IPI-EASE GPECIFY A30VLj <br /> 1. List up to tan addresses in the space above. Seiect the typos) of files from the list above by checking <br /> the bppropriat. box(es). At 190st one file type MUST be selected. Fax to (2091464-01H or mall to filo t <br /> addrq"indicated above. <br /> 2. EHD will notify the applicant If any EHD files exist An appolntment for review will be confirmed <br /> approximately five business days but no later than ten (10)days after receipt of application. The fifes <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 on by EHD staff may not be Immediately available for review. A new <br /> application may be submitted when the file is available. <br /> 4. Any file not returned In the same condition as reiea%,ed will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a $89,00 deposit prior to review. <br /> 5. `TENTATIVE appointment dates must be confirmed with EHD staff. <br /> G. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE, TIME ' <br /> -.r <br /> DATE CONFIRMED PHONE PAX' INITIALS <br /> i <br /> REVIEWED YES NO REVIEW DATE <br /> OPI pr <br />