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LIG.16.200213 2:46PM464eRPEX ENVIROTECH,INC. ENVIR(114ENTAL HEALTH N0.085 P.2AGE Q2 <br /> "L)Art:a;V[v90 <br /> SM- JAQUIN COUNTYPUBLIC HEALTF, SERVICE <br /> ENVIRONMENTAL. HEALTH DIVISION (o <br /> 304 EAST WEBER AVENUE,THIRD FL00R loll I_� ` IF[ <br /> STOCKTON CA 95202 <br /> (209)468-3420 AUG 1 8 2002 <br /> RU§ PUBLIC RECORDS RELEASE APPLICAT1 <br /> APPLICANT V t!iY1V1 l ^� <br /> �� BUSINESS/AGENCY l�T.l�P,�X EhUltr~o T/SERVICES <br /> ADDRESS II �^ <br /> PHONE CSS 1—O FACSIMILE S I—cU <br /> TENTA IVE'.A OINTMENT DATE TIME <br /> (PIe a �10 bus M d Irom da of application submitral <br /> CHECK Box To E7CPPD REgUFST•589,00 Fa—R>rgUES P O SED M 3 BUSINESS DAYS <br /> SIGNATURE OF PLIC N DATE O <br /> 1LE ADDRESS T}H1S SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> q& /l 5 'Tr N <br /> 2� <br /> Lincal a4 <br /> r r,52 <br /> \v �1 r1rl n <br /> \-,Iti 1141, uJ,U u L�3 LL <br /> 5 / r <br /> W /Oh i - <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> 1euNt)1:RGROUND T K(U5"r)CLEANUP 5tl•E(LOP) <br /> ❑ HOUSING ABATEMENT O sOL1D WASTE FACILITY <br /> M OTHER CLEANUP M(NON OP) ❑ FOOD FACILITY O SOLID WASTE VEHICLE <br /> UN4ERGRQUND TANK(KION RINGlREMOVAL) Q DOG KENNEL d DAIRY � PST <br /> ed HAZARDOUS WASTE GENE OR O CHICKEN RANCH <br /> 0 TIERED PERMITTED FACIL ❑ MOTELIHOTEL 0 PUMPER TRUCIUYARDICHEM TOILETS <br /> O TATTOOISOpY PEIRCING 0 POOLWA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICA WASTE ILITY ❑ PUBLIC wATaR SYST>;M Q OTHER(PLIZASE SPECIFY ApOVE) <br /> 1. List up t1 ten ad resses in the space above. Select the type(s) of files from the list above by checking <br /> the app priate ox(es). At least one file type MUST be selected. t:ax to (209)464-0138 or mail to the <br /> ress ndiC'a above. , <br /> 2. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approxi ately five business days but no later than ten (10) days after receipt of Application. The files <br /> will be h Id fora maxImUrn of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A filo that,is acth ell6bing worked on by EHII staff may not ba Immediately available for review. A new <br /> applicati' n may be submitted when the file Is available. <br /> 4. Any file f�ot 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 app 3intment dates must be confirmed with EHD staff. <br /> .6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED POINT& ENT DATE, TIME <br /> DATE CONFIRMS PHONE FAX INITIALS <br /> REVIEWED Y NO R1=V1EW DATE '" <br />