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. , 15/2005 18:55 FAX @i 0021002 <br /> OATSE�CENF-D SAN JOAQUEN COUNTY <br /> LS 1`l is Lv1 ENVM0NMENTAL HIALTff DEPARTMINT <br /> 304 E Weber-Ave 3"Floor Stockton, CA 95205 <br /> NOV 1 6 454-0138 Web'.w�vw.co.san joaqumca.uslebd O <br /> ���) 468-3420 Fax: �209} <br /> ENVIRONMENT HEALTH PUBLIC RECORDS RELEASE A.PPLXCA.' bri <br /> PERMIT SERVI <br /> SUSINESSIAGENCY; <br /> APruCANT: <br /> IA <br /> ADDRESS: � ��.•� . <br /> 4e-0 U z-1 <br /> PRONE: <br /> u FAeSIMILJ :•�, ZD�I ... q <br /> TEN7ATN1~''APf'blmTMF-KT DATE:_ t -L- <br /> (Pteasa allow In business days kam date of apPrcaMan submittal) <br /> CHECK 'BOX TO EXPEDITE REQUEST 3493.00y FEE-REQUEST PROCESSED IN 3 aualNESS DAYS <br /> TURE OF APPLJCANY DATE <br /> SIGFtA Daparunenttlse 01* <br /> UHrr <br /> FILE ADDRESS <br /> ❑ unit 1 <br /> D. r }:)� <br /> Dc�a K-3 • ' a �g5 unit 2 <br /> SC <br /> '• ' Unit 3 ' <br /> o <br /> Rai 0 unit s <br /> rc S� <br /> 1a. saw ! 1 1 , (• <br /> ENT FILES <br /> -ENVIRONMENTAL H !T <br /> EAH DEPARTM - <br /> OP Q HOUSING AIIATEME,NT Ui.90LEf7 WASTE FAC�Lf7'Y <br /> UMDERGROUND TA1 K(UMT)CLEANUP SrM <br /> (LOP) a Fano FAcILIT'r t3 SOUD WASTE VEHICLE ; <br /> OTHER CLEANUP SITE(NON•LOP) M VAMY <br /> I& uNDf_RGRU[IND TANK(40NITORINGIREMQVA4 p 0 DOG"MME M <br /> GHICIiEM RANCH -PKG TREATMENT PLANT <br /> a Rk AR06O S WASTE GENERATOR M MOT1rLIH i L a PuMPRTKUCKIYARWCHCU TOILET'S <br /> ❑ TIERED PERMrMD FAC11-M a POOLtSPA M LANA USE APPLICATION SITES <br /> C3 TATTQQlAGaII PIERCING <a OTHER(PLEASE SPECS <br /> d MSDICAL WASTE FACILITY <br /> 1_ Ust 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 least one file type MUST be selected. frax to J201 16:4-0 38 or malt to the <br /> address-indicated above. <br /> . EHQ wilt notify tl,a applicant if any EHD files exist An appointment for review will ble�U�rMed files <br /> approximately five business days but no later than ten (10) days after receipt of app i <br /> wiil be held for a maximum of five business days for review. Appointments should be scheduled <br /> Accordingly. <br /> ' rked on by EHD staff may not be immediately available for rerriew• a'ne <br /> g. A file that Is actively being wo <br /> application Tnay be submitted when the file is ayladable. a <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$93.00 deposit prior to review. <br /> S, 'TENTATNE appointment dates must be confirvned with EHD staff. <br /> 5. A{aplieatlans raceived after 3.00 PM wilt be processed the next business day. <br /> MF�L7l R41NT141ZNT ATE `.r + :::�: _; __•� <br /> "•`':= PHONE . FA3C' <br /> REVISNED YES NO REVIEW DATE' <br /> /-7 <br />