Laserfiche WebLink
n _ �asuvu� -v t! UeL \J hll 1�� L� 1 <br /> SAN QUIN COUNTYPUBLIC HEALTH St ICES <br /> M ENVIRONMENTAL HEALTH DIVISION f <br /> 304 EAST WEBER AVENUE, THIRD FLOOR JAN 0 2 2001 <br /> STOCKTON CA 95202 <br /> (209) 468-3420 NVIRONPvIENT HEALTH <br /> PUBLIC RECORDS RELEASE APPLICATION PERMIT /SERVICES <br /> APPLICANT -y I ' r.� ` Ste, � 1/1/� OUSINESSIAGENCY 1C.Y\V 1 `(nV\ me I WWF_-t c�eA(P' ba4 <br /> AODRESS l� U.Y�\� �YSI [tet Tt'V �Y\�A �-� AC rOLNCIQdnI r A cOs25 <br /> PHONE 9 L 51 L- 4500 FACSIMILE C91,(0 <br /> TENTATIVE" APPOINTMENT DATETIME 9 . 34 Ar✓\ <br /> (Please give Ito W business da s from date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST - $117,00 FEE - REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT <br /> — FILE ADDRESSTHIS SIDE EHD STAFF USEONJ , L . YY <br /> PROGRAM ELEMENTS SEARCH <br /> z MEetrin AYextuf. n <br /> chI roc.y+art 4 .ShiIYD PF <br /> ' � ocaf c SfocYFsF-J�i IJ � <br /> ENVIRONMENTAL HEALTH DIVISION FILLS <br /> UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> ❑ OTHER CLEANUP SITE (NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> +a UNDERGROUND TANK (MONIrORINGIREMOVAL) ❑ DOG KENNEL - ❑ DAIRY <br /> ❑ HAZARDOUS WASTE GENERATOR ❑ CH !CKEN RANCH El PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY Cl MOTEL/HOTEL ❑ PUMPER TRUCKlYARDICHEM TOILETS <br /> n TATTOOIBODYPEIRCING ❑ POOLfSPA - ❑ LAND USE APPLICATION SITES <br /> ❑ MEOICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER (PLEASE SPECIFY ABOVE) <br /> 1 . List up to ten addresses to the space above. Select the type(*) of files from the list above by checking <br /> the appropriate box(es) . At least one file type MUST be selected. Fax to (209) 464-0138 or mail to the <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 ten (10) days after receipt of application. The files <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 released will be reorganized by EHD staff at the expense <br /> of the applicant. Future file roviows by the same applicant may require a $87-00 deposit prior to review. <br /> 5. "TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm 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 />