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-----12r9/21/20B4-_114;22 9252 21 AEI- CONSULTANT SF) - ; , . PAGE'. B1 - <br /> 01/03/2083 15:16 46481 ENVIRONt-NTAL IH PAGE B2 <br /> ,,......... <br /> grt�t,Oc IAwnt:n <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> — - ENVIRONMENTAL HEALTH DIVISION <br /> r 304 EAST WE13ER AVENUE4 THIRD FLOOk <br /> S F P 2 1-2004 STOCKTON CA 95202 <br /> (209)468-3420 V1 <br /> 'E i'ai� _;;��v'���sl r;eA.LiH• PUBLIC RECORDS F FLF-ASE APPLICATM <br /> SAPPLICANT t S A BUSINE551AGENCY ITGI (• u1•�,K-F� <br /> ADDRass2500 OVYI o Diu\Q Waly C%Glc �) •f5a� <br /> PHONE_ p1:2-5.— 2B 3 ~'(p 00 0 FA&IMI1P 25- •2-g--3 t <br /> TENTATIVE,APPOINTMENT nATE TIME <br /> ' (Phase give 7 to 10 business drys tram tato of aPPtlOetton submittal) <br /> © CHECK BOX TO EXPEDITE EQuEST• .O0 F QUEST PROCESSED IN 3 BUSINESS DAYS i <br /> "SIGNATURE OF APPLICA DATE <br /> FILE ADDRESS THIS SIDE END STAFF USE ONLY <br /> PROGRAM 9LEMEN1S SEARCH <br /> +A44,r <br /> ego w¢S-t—Ira.-,•� �:., . �1 t�;.- <br /> 4-I'L, e s p,%V1 <br /> tS 2.8 ;vial <br /> -1 <br /> 33 V. L <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> rfMUNDERGROOMO TANK(UST')CL.EANIfP Srre(LOP) 0 HOUSING ABATEMENT O-SOLID WASTE FACILITY <br /> DTHER CL.EAFgUP SITE{NON-LOP) l7 FOOD FACIUTY tl SOLID WASTE VEHICLE <br /> UNOERCROVfID TANK{MONITORINGIREI�AOVAL) II qOG xENNL-L ❑ OdIRY. <br /> HAZARDOUS LVASTE GENERATOR r3 CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> ERED PEn'iTMO FAC1LM 0 MOTEUROTEL fl LAND USEPER "PUCATtON IT YOILE7S <br /> TA1ToclioODY PEinomoG POOVSPAl,AWO VSE APPIJCATIOti SITES <br /> MEDICAL WASTE FACILITY , 0 OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List Up to ton addresses In the space above. Select the typ (s)Of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be sclacted. Fax to(209)464-0130 or mail ta_the <br /> address indic'ated above. • <br /> 2. EHD Will notify the applicant if any EHD rites exist. An appointment for review will be confirmed <br /> approximatoly five businoss days but no later than ton,(10)days after racelpt,of application, The tiles <br /> will behold for a maximum of five business days for review. APPointments should be scheduled <br /> accordingly. <br /> 3. A file Lhat;ls,actively baing worked on by EHO staff may not be tmmodlately availabte for review. A nev <br /> applicaNan may he submitted when the file is available. <br /> 4, Any fire not returned in the Same condition as released will be reorganized by EHD staff at the expenst <br /> of the applicant. Future rile roviews by the same applicant may require a$69.00 deposit,prior to revicv <br /> 5. `TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm Will be processed the next business day. <br /> - CONFIRMED APPOINTMFNTDAT E, TIME <br /> DATE CONFIRAIED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br />