Laserfiche WebLink
e?r2..17VS 7.8:47 92594428(l TSG PA7,7 94 <br /> EHL'LOG NtIMHER <br /> N ?E ii LEAN JOAQUIN COUNTY <br /> 'lJ � EN-VICiONMENTA.L HEALTH DEPAIt 1Td XN'T <br /> SEP 2 2 �a0fi 304 p'a'sI.Weber Avenue,3'1 Floor,Stockton;CA 95202-2708 <br /> i`A pllnne; (209)468-3420 Fax:(209)464-0138'Web;Www.sjgray.org/end <br /> 50* <br /> ENVIRONMENT f111ENA P IC. E <br /> LRCORDS RELEASE APPL[CATTO1N Z <br /> 3 <br /> / pWIP 0A,N <br /> PHON1=(FI <br /> TENTATIVW APPOINTNEW-DATE: - - T"'(Please a;iow 10 mires days from date of application submiHai-°Tantaeh/e only-must ba cenflrmed) <br /> C7 CHECK SOX TO E'xPPDiTE F:E%wu-s9&.00 PEE(GASH OR CHECK ONLY)-REQUEST PRIJCESSED IN 8 DUSINW95 DAYS <br /> SIONATURE OF APPLlf7ANT DATE „�— <br /> „uayamxu��� <br /> �bicwfToniC Infoelnatlen:�1<j i_Ist(e]19Iap-Aascriptlon: �.a �„�,,,,,,� <br /> FILE ADDRESS � EHC?�ONLY <br /> � <br /> SteeetS S Name City unle I <br /> A <br /> � > 1 t) <br /> t1nE2' <br /> 4e — lr G0 Ute. <br /> 3 ar r�� � f r l <br /> It <br /> J-7 <br /> Sgsarl4'7D 37ate Fango of Infonlsat(on RORoested:From _ --_.__...--._._.._ to - - -�---_- <br /> EFf1 RONMENTAL HEALTH DEPARTMENT FILES <br /> tV-U}wENCRouNa TAN,a(U-*T)CLWIr Un(V P) ©Hou51NG ARATEMEhT ig Soul)WASIE.FACILITYNOWLE <br /> ,)9S MER CLEANOP StTE(RON-LOF) U Foau FAvnWAIS ETIRE <br /> 17 UNOERG.0.'OuNe TANK(MONrromNOntunYVAL) El DOG KENNEL at DAIRY <br /> Fiaztapous WASTa GENERATOR V-DHMMN RANCH SAWAsTEwAirR rwATumT Pvw <br /> $1TlEREAL€tgtTiEOFANOTr 17MOn3IHOTEL JRPUaPFATRUCKMARRICNEVITOKM <br /> C9 TATrO019OVY PW'01 * ©POOLISPA P!-kANf,Uas APPUCATICN WM0 <br /> X%%PIDAL WAST✓:FAMMI e1 OTHER(PLEASE 5PFC3Fr)-- ---••-- <br /> _ VVELL AND SEPTFC PERMrf RP;CDRD9 ARE AVARMtr FOR REVIEW- NIONDAY-SWAY 3:00 AM-5:9UPM - F][GLI NG'1-00i1DM"r M- <br /> i. List up to ten addresses In the space above. Select the types)of files from the list abave by checking Ina appropriate <br /> box(es). At least one ifie type MUST be selected, Fax to(209)484-OTE@ or mail f0 the rddresA indicated eYDYe. Addmss <br /> ranges will not be accepted-Ear additional asstwtance with file addresses,contact Cm EMU,Applieaticna mcelved atter <br /> s:00 pm will be ploaessed the next business day. <br /> . The;EHD will notify the applicant"Any EHD file.,exist. An appointment for review will he confirmed approximately ten(10) <br /> nays after rvc'elpt of application. 711 files will be held for a maximum of five business clays for rnvlaw. b0pnlrtments <br /> ThoMtd tv anheduled sa:eardingty, <br /> 3, .A the that is actively-being worlred on by EHO staff may not be Immediately available fur review. A new appileat(on may bt <br /> submitted when tho file Is avallable. <br /> 4. Any file nut returned in the same condition as released will be morganlzed by EHO stiff atthe expense of the Rppiloant <br /> Future file reYRew-s by the sarne applicant may require a$95.00 deposit prior to review. <br /> EHD USE ONLY <br /> I <br /> _J <br /> R1a aausw P'<; <br />