Laserfiche WebLink
FRAM Geo-Phase EnvirornmentaC. FAX Ni]. 2095690295, j ` Sep.. 18 2003 03:22PM P2 I <br /> DATE RECEIVED. 1 i=HO LOG NUMBER <br /> } SAN JOAQUIN COUNTY <br /> FEEj �''� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave 3'F10"Or Stockton; CA 95205' <br /> SEP 1 8 24Q3 . <br /> (209)468-3420 Fax: (209)46.4-0138 Web:www.co.san-jQaqwn.ca.us/ehd 072 <br /> ENVIRONVIENT HEALTH <br /> PERMITISERVIGES PUBLIC RECORDS RELEASE .APPLICATION <br /> APPLICANT' i'�• <br /> 7`Of' 13USINE551AGENCY: y I <br /> ADDRESS: 2 ?2 7 16144 9 4MW.r <br /> PHONE: 6 FACSIMILE:--i � De'• 7 y -- <br /> TENTATIVE'APPOINTMENT DATE: 7 - Time: �� ! <br /> (Please allow 10 business days from date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$23,00.FEE-REQUEST PROCESSED 1N 3 BUSINESS PAYS <br /> SIGNATURE OF APPLICANT DATE_ _ <br /> Department Use Only <br /> G FILE ADIj�R/ESS UNIT <br /> 1. Soret it qd i- "'V _' �C.' ./ a Unit i <br /> �. Slrcel •C3l �' C So7tl <br /> st e•.t �I �. <br /> Z.L/ unit 2 t �} <br /> 4. 3lteet <br /> ❑ <br /> City <br /> �f! <br /> 5. 6lrcol <br /> City .- *Unit <br /> 3 <br /> e. Street <br /> 7. Vveet C! 4 <br /> B. Street CI . <br /> 9. stree! GLY Q unlit 5 <br /> ENVIRONMENTAL. HEALTH DEPARTMENT FILES � <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP). ❑.HOUSING ABATEMENT GT SOLID WAS J f IL j <br /> ,OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY C] SOLID WASTE VEHICLE <br /> NDERGROUND TANK(MONETORINGIRF-MOVAL) ? © DOG KENNEL Q DAIRY <br /> ❑ HAZARDOUS WASTE GENERATOR -L1 CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACIOTY ElMOTELIHQT•EL -Cl PUMPER TRUCKlYARDICHEM TO <br /> . <br /> Q POOLISPA 0 LAND USE APPLICATION SITES <br /> Cl MEDICAL WASTE FACILITY <br /> ;F p.DTHER PLEASE SPECIFY) <br /> ❑ MEDICAL WASTE FACItIT'Y {_. <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 box(es). At leas_ torte file type MUST be selected. ;Fax to 209 464-0138 or mail to the <br /> _ <br /> address indicated above. <br /> 2. EHD will notify;the applicant if anyjEHD files exist. An appointment for review will be confirmed <br /> approximately five business days but ria later than ten(10)days after receipt of application. The files <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 acIiveiy being worked!orr by EHD staff may nbt-be immediately available for review. A new 1 <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 appllcar t. Future file reviews by the same applicant may require a$93.00 deposit prior to review: <br /> 5. *TENTATIVIEE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day- <br /> .. r <br /> CONFIRMED APPOINTMENT-DATE .. : .:; 71M>» <br /> DAT1=CONFIRMED �_ PHONE FAX-- INITIALS <br /> REVIEWED K IES NO . REVIE=W DATE <br /> EHD 49-02406 <br /> .�erzooa - h <br /> ,C <br />