Laserfiche WebLink
84/07/26 4` ix}284 38 AGE STOCKTON PAGE. 01/01 <br /> lb 900 roc NUMSFR <br /> A -� . . QUIN COUNTYPUBl,1C WEALTH S ,-W IGES � <br /> APR (} 7' 2Q03 ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR • f <br /> STOCKTON CA 95202 # <br /> ENVIKONMENT HEALTH (tog)468-3420 .3 C <br /> PERNIIT/SERA61%LIC RECORDS RELEASE APPLICA'T'ION <br /> APPLICANT 1MW Ud;7T BUSINESSlAGENCY,��� �� � <br /> ADDRESS rJQ d GR 9-50213- <br /> PHONE ({! !' �V�J FACSIMILE <br /> TENTATIVE`APPOINTMENT DATE-- TIME _ <br /> (Ploase give 7 to 10 business days from AdIt, applicatlon sutnmTitdi) s <br /> CHECK SOX TO EXPEDITE REQU T.S0j'00 FEE—REgUEST ROCESSED IN 313USINESS DAYS <br /> SIGNATURE OF APPLICANT DATE _ <br /> FILE ADDRESS <br /> It �� <br /> If <br /> i <br /> is If it r r-a <br /> 7 If r* ♦� !r �Ji - <br /> ENVIRONMENTAL HFALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEAN-UP SITE(LOP) ❑ HOUSING ABATEMr;NT ❑ S0LID WASTE FACILITY <br /> OTHER CLEANUP SITE;(NON-LOP) 17 FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY ' <br /> HAZARDOUS WASTE GENERATOR © CHICKEN RANCH 13 PI(G TREATM1:NTIPLANY <br /> a TIERED PERMITTED FACILITY ❑ MOTEEIHOTEL ❑ OIJM,ICR TRUCIVYARD/C14EM TOILETS <br /> ❑ TATTOOISODY PEIRCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM r2 OTHER(PLEA'se SPECIFY M8ovE) <br /> 1. List up to ten addresses in the space above. Select the typo(s) of files fr6m the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0138_or rggiil 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 film: <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 lie immediately availabft for review. A now <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 $78.00 dopo to <br /> 5. *TENTATIVE appointment dates must be confirmed with EHD staff, fi <br /> " ' j a' <br /> 6. Applications received after 3:00 pm will be processed the next business clay. T ' � <br /> CONFIRMED-APPOINTMENT DAT>= TIME <br /> DATE CONFIRMED _ PRONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> RM 00 14 0110=0 _ <br /> i <br />