Laserfiche WebLink
04/04/2005 15:53 �2093694,inq NEIL ANDERSON EM` ' "RO PAGE 02/0 <br /> DATE RECEIVED 4 CI-4D LOG NL ER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL I-T.EALTH DEPAaRtTMk NT <br /> 304 F Weber Ave 3'6 Floor Stockton., 2{�5�� _ <br /> P� �y ..`.i3 <br /> 209 468-3420 Fax: 209 464-0138 Web: www.co.sa �a ILi7i ..ca.us�lii <br /> SAN 0 AUNTY <br /> PUBLIC RECORDS RBEEASE APENT <br /> ��Al.... <br /> APPLICANT; ,C�(t( BUSINESSlAGENGY: <br /> ADDRESS: <br /> _ DST PHONE: .,, <br /> TENTATIVE"APPOINTMENT DATE: Time; <br /> (Please allow 4o business days from date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$93.00 FEE—REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANTDATE <br /> Department Use Orl <br /> FILE DRESS UNIT <br /> unit <br /> T�1r.�'L.. 2 <br /> Cnr � <br /> 3. street .)1V. _,; Unit 2 <br /> 4. S1r5T1 CA -QAA. uw <br /> 8. street I clr `•* <br /> :1! U t3 <br /> S. Streetft <br /> �_ Slrect �, ralz , Surd'► � ON N Unita <br /> CA <br /> a. Sweet _ <br /> V. Street _ _ Gt ❑ Unit 5 <br /> zo, Street -r <br /> ENVIRONMENTAL:HSALTH DEPARTMENT FIDES <br /> K UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 MOUSINO ABATEMENT AV SOLID WASTE FACILITY <br /> Az OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLr, <br /> R3 UNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL ❑ DAIRY <br /> Pa' HAZARDOUS WASTE GENERATOR Q CHICKEN RANCH <br /> 931E7 PKG TREAT PLANT <br /> TMENTIERED PERMITTED FACILITY Q MOTEIJHOTEL [3 PUMPER TmEN/YARDlCHEM TOILE <br /> TATTOO/Booy PIERCING © POOIJSPA 13 LAND USE APPLICATION SITES <br /> 13 MEDICALWASTE FACILITY 0 OTHER(PLEASE SPECIFIC <br /> 1. List up to ten addresses in the Space above. Select the type($) of files from the lis t aboye by check <br /> the appropriate bOX(es).'At least one file type MUST be selected. Fax to 209 464-0138 or mail to th <br /> address indicated above. <br /> 2• EHD 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 tori (10) days after receipt of application. The fill <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 workcd on by EHD staff may not be Imfrled)ately available for review. A r <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 staff at the exper <br /> of tho applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to revi <br /> 5. "TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 prn will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> cwn Jrt��.rufi <br />