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10/36/2002 14:21 46401• ENVIPONMENTAL HEA PAGE 01 <br /> w1iL—,10oLt1 <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES E��sG4 <br /> ENVIRONMENTAL HEALTH DIVISION 0 M� 1 Y 304 EASY WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 93202 <br /> (209)460-420 NOV 0 1 2002 <br /> nn PUBLIC RECORDS RELEASE <br /> ��APPLICATION <br /> PMTftttff-ftAPPLICANT G'"( _/� /� BUSINESS/AGENCY 1 1 E ' /�/�L( T H <br /> ADDRESS'�� �� ./- O-!Z.Q. eo y � ICES <br /> PHONE5j 3 3FnGsiMILE �'1 a r� C, rJ_ 5� 7•' . <br /> TENTATIVE'APPOINTMENT DATE / Q l Z TIME /r r, ', )• AN <br /> (Please Alva T to 10 busln ss da from date of appllcallon submitlar) <br /> CHECK DO'X* <br /> TO EXPEDITE REQ Est• 7�0te,<(EQUEST0 Jf S <br /> SIGNATURE OF APpLICAN L U � 51 TE 3J OZ <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> ` - 1 and Tleue k <br /> �e Pont M U LA t Obs <br /> ->ry <br /> S . IPom RLfLiL PiwtF-C �• <br /> 2 ec.`cti. (• r_. <br /> rPcHf ox <br /> � � •r �t�itd-� <br /> b ,�'-% ` `�T�1' � 'f� Crur►t �i_:7111 `r.K- r , ��.1.: • <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT O SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY O SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> ❑ HAZARDOUS WASTE GENERATOR D CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> O TIERED PERMITTED FACILITY O MOTELIHOTEL ❑ PUMPER TRUCK/YARDICHEM TOILETS <br /> O TATTOOIBODY PEIRCING ❑ POOUSPA O LAND USE APPLICATION SITES <br /> O MEDICAL WASTE FACILITY % ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1, list up to ten addresses In the space aboVe. Select the type(s)of files from the list above by ckecking <br /> the appropriate Oox(as). At least one filo type MUST be selected. Fax to(209)464-01311 or mall to the <br /> address indicated above. <br /> 2. EHD wilf notify the applicant if anyEHD files exist. An appointment for review will be confirmed <br /> approximately five buslness days but no later than ton(10)days after receipt of application. The files <br /> will beheld for a maximum of five•buslness days for review. Appointments should be scheduled <br /> ! accordingly. <br /> 3. A file that•ls actively being worked on by EHD staff may not be Immediately avaiinble for review. A naw <br /> application may be submitted when the file Is ava'Ilable. <br /> 4. Any file not returned in the same condition as relonad will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the same appllcant may require a$89.00 deposit prior to review. <br /> 5. "TENTATIVE appointment dates must be confirmed with EHD staff. <br /> G. Applications roceived 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 /> T •d dLi, :SO 20 TE 400 <br />