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V p, G.16.200210 2:46PM4640nPEX ENVIROTECH,INC. E�iVIRGIVENTAL W-PLTH N0.085 P.2AGE Q2 <br /> ~u.,re u�ceNee <br /> SAN_ JAQUIN COUNTYPU13LIC HEALTI•. SERVICE <br /> ENVIRONMENTAL HEALTH DIVISION (o <br /> 304 EAST WEBER AVENUE,THIRD FLOOR loll CIE ILII <br /> STOCKTON CA 95202 <br /> (209)468,420 AUG 1 8 2002 <br /> PUBLIC RECORDS RELEASE APPLICAT1 <br /> APPLICANT � 1�J_"BUSINESS/AGENCY ^19 iE.h\11rXT/SERVICES <br /> ADDRESS ^^ <br /> GCA <br /> PHONE jFACSIMILE SI -tD <br /> TENTAVVEAPPc3lNrm9NT DATE TIME 2.1111 1 <br /> • (PI���10 bus ess d tram da of application submutan - <br /> CHECK BOX TO EXPED REQUEST•;99,00 FEE—REgUES p�0 SED M 3 BUSINESS DAYS <br /> SIGNATURE OF JPPLICA N DATE O �• <br /> 1LE ADDRESS Tills SIDE EHD STAFF USIA ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> • �' Z �I � 7'r N <br /> 40 W <br /> Llncal d <br /> / �a <br /> `v �1 nr, n <br /> ti 1) 1k.V u U <br /> ENVIRONMENTAL.HEALTH DIVISION FILES . <br /> eUNP ERGROUND TANK(UST)CLEANUP SrTE(LOP) ❑ HOUSING ABATEMENT D SOLID WASTE FACILITY <br /> D OTHER CLEANUP SITE(NON OP) 13 FOOD FACILITY O SOLID WASTE VEHICLE <br /> I7 UNOERGRQUND TANK(MON RINGIREMOVAL) C1 DOG KENNEL 10 ���PLANT DAJ <br /> ed HAZARDOUS WASTE GENERATOR O CHICKEN RANCH <br /> M TIERED PERmrTTED FACIL C1 MCTEI.IH0nL C3 PUMPER TRUCkrYARDICHEM TOILETS <br /> D TATTOOISOPY PEIRCING O POOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY , O PUBLIC WATER SYSTEM 0 OTHER(PL.FASE SPECIFY AaOVE) <br /> 1. List up to ten adi Iresses 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 indicatR: above. <br /> 2. EHD will notify tie applicant if any EHD files exist. An appointment for review will be con[irmad <br /> approxImately five business days but no later than ten (10) days after receipt of application. The files <br /> will be he�ld for a aximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A filo that,is acts elf bWng worked on by EHO staff may not be immediately available for review. A new <br /> application may a submitted when the fila Is available. <br /> 4. Any file not ret ed 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 appointment dq es 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 Y NO REVIEW DATE '" <br />