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,_zt. IG.16.200213 2:46PNr 64eAPEX ENVIROTECH,INC. QIVIR"ENTAL HEALTH N0.085 P.2AGE 02 <br /> '"u.,re u�veNre <br /> SAI )AQUIN COUNTYPUBLIC HEALTH, . ERVICE <br /> ENVIRONMENTAL HEALTH DIVISION o <br /> �1 304 FAST WESER AVENUF,THIRD FLOOf2 �V`' L ) <br /> STOCKTON CA 95202 <br /> (209)468-3420 AUG 18 2002 <br /> PUBLIC RECORDS RELEASE APPLICAT1 <br /> APPLICANT BUSINESSIAGENCY2!j32jLK E�:: \3(rD1E: T/SERVICES'T <br /> ADDRESS 11 <br /> PHONE FSS(—O FACSIMILE 51 -0 <br /> vasw <br /> TENTATIVE',APPOINTMENT DATE 1U4E <br /> (Pita to 10 bus egg d from da of�pplleallott subrnittan <br /> CHECK BOX TO�'EDIT!E REgUEST•Moo FF—REQUPS Pfoc SED M 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICAN DATE O <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> Zq& 7"r N <br /> Z 40 W WX <br /> LIricol cf <br /> Z.Z e4i �i <br /> nnn n <br /> Ut <br /> Q E -A Tia <br /> !1 <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> eUNDERGROUND TANK(U CLEANUP SITE(LOP) 0 HOUSING ABATEMENT M SOLID WASTE FACIL Y <br /> 0 OTHER CLEANUP SrM(NO -LOP) ❑ FOOD FACUTY O SOLID WASTE VEHICLE <br /> 17 UNDERGROUND TANK(Mid 4MRINGIREMOVAL) ❑ DOG KENNEL O DAIRY <br /> HAZARDOUS WASTE GENE TOR C1 CHICKEN RANCH 0 PKG TREATMENT PLANT , <br /> 0 TIERED PCRMrrrED FACiLt 1Y ❑ MOTELIHOTEL o PUMPER TRUC"ARDICHEM TofLETS <br /> 0 TATTOOISOPY PEIRCING 0 POOLISPA ❑ LAND USE APPLICATION SITES <br /> CI MIEAICAL WASTE FACILITY , O PUBUC WATER SYSTEM 0 OTHER(PLEASE SPECIFY AEQVE) <br /> 1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checking <br /> the appropriate ox(es). At least one file type MUST be selected. Fax to (209)464-0138 or mail to the <br /> ress indica above. <br /> z. EHD will notify a Applicant if any EHD fees exist. An appointment for review will be confirmed <br /> approximately a business days but no later than ten (10) days after receipt of,�ppiication. The files <br /> will be held for maxlmum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A filo that,is active*Wne worked on by EHP staff may not bo 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 reviews by the same applicant may require a $89.00 deposit prior to review. <br /> 5. *TENTATIVE ap ointment dopes 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 INMALS <br /> REVIEWED YES NO REVIEW DATE '" <br />