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O SEP.25.2002t1i12:4GPrfl6'10;AR(-ADIS GERAGHTY&NILLER/JSP{Rp(. EWAL ?ALTH NO.277 P.ID 1� 92 <br /> DATE ftscaV <br /> • Sh,. JOAQUIIJCOUNTYPUBUC HEALTH <br /> �ol > SERV,}ICE <br /> e"iNMENTAL HETDIVISION <br /> f <br /> , <br /> lifb7- <br /> , <br /> 0, 111 <br /> 0STOCKTON CA 95202 <br /> (209)468420 <br /> PUBLIC RECORDS RELEASE APPLICATION 2 5 2002 <br /> APPLICANT F}— (/05co f f-- 9USIN9=A(;BNCY �{?.� IS F- j\/IRn mF IT HFAITH <br /> "DRESS o O iv,. PERMIT/SERVICES <br /> PHONE Cs-lo) Z33- 2�Q FAcsRY11LE sro �� — <br /> •TENTATNE".APPoi <br /> NTDAL�NT DAWloh <br /> d <br /> ' TUNS , "fi �• ,�/ <br /> (PlQasa givead fr !�of lletitlon submittal) <br /> RO�f ATO1rXPOEST PFtO ES EDI 3EUSINESZDAYS <br /> SIGNATURE OF APPLICAN ` DATE p�_ <br /> FILE ADDRESS THIS SiDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> (� <br /> O o K7 Lt L( <br /> ✓2 L� L.- Ll <br /> > L, LL L, <br /> O <br /> I� <br /> 5 Lt <br /> NVIRONME=NTAL HEALTH DIVISION FILES <br /> F <br /> PLRGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT CISOLiD WASTE FACILITY <br /> ER CLEANUP SITE(NON-LOP) M POOP FACiUTY C1 SOLID WASTE VEHICLE <br /> QERGROUND TANK(M0NrT0RING1REh10VAL) ❑ DOO KENNEL. Q DAIRY <br /> ❑ HAZARDOUS WASTE GEN> BATOR M CHICKEN RANCH L7 PKG TREATMENT PLANT w <br /> ❑ 71EREII PERMITTED FACILITY D MOTtL/HOTEL CI PUMPER TRUCK/YAAI31CHEM TD(,LETS <br /> M TATTOOMODY PEiRC(NO A POOUSPA ❑ LAND USE APPLICATION SEMS <br /> r] MEDICAL WASTE FACILITY C1 PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE') <br /> 1. List up to tan addresses in the space above. Select the typo(s) of files from the list above by checking <br /> the appropriate box(es). At toast one file type MUST be selected. Fax.to (209)464-0118 or m is i to to ti <br /> addw�s indicated abpyp, <br /> 2. EHD will notify the applicant if any EHD flies exist.' An appointment for review will be confirmed <br /> approximately five business days but no later than ten (10) days after receipt of application. The fires <br /> will bo held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly, <br /> 3. A fila that is actively being worked on by EHD start may not be immoLTately available for review. Anew <br /> application may be submitted when the file is available, <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD staffat the expense <br /> of tiro applicant. Future file reviews by the same applicant may require a $89,00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications receivcd after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOiNTMENT DATE,^ TIME <br /> ".r <br /> DATE CONFIRMED PHONE PAX' INITIAL..$ <br /> REVIEWED YES NO REVIEW DATE <br />