COMPLIANCE INFO_1996-2004 - Laserfiche WebLink

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_�l APPI.J ADDRESS PHONE. IWVIRONMENTAL HEALTHD06 304 EAST WEBER AVENUE. THIRD FLOOR STOCKTON Irk,BLIC RECORDS RELEASE APPLICAT1011 0+468-3420 1 U_)J 1 13U$INESSIAGENCY FACSIMILE ° ° T a z000 TENTATIVE' APPOINTMENT DATE�'3 nato &e_ TIME ?"306M.-__ (Please give 7 to 10 twin"& days from date W applic4tion submittal.r t��'ra I tes. CHECK BOX TO EXPEDITEIZEC2U - - . 78.QQ FEE - P.E Si PROCESSED IN 3 BUSINESS DAYS � ne_Qb WP 1e'& Wm YYLtcrop- IiW ... SIGNATURE OF APPLICANT DATE UNDERGROUND TANK (UST) CLEANUP SITE (LOP) OTHER CLEANUP SITE (NON -LOP) UNDERGROUND YANK (MONITORINGIREMOVAL) RAZARDOUS NYASTE GENERATOR 0 TIERED PERMITTED FACILITY �n q ❑ TATTOOiBODY PEIRCING ❑ MEDICAL WASTE= FACIL17 Y I• ❑ HOU$ING A T ENT ❑ SOLID WASTE FACILfIY ❑ FOOD ACIL ❑ SOLID WASTE VEHICLE DOG EL ❑ DAIRY S5'Tr=lJHOTEl_GK N RANC ❑ PICC TREATMENT PLANT d PUMPER TRUCKIYARDICHEM TOILETS Q POQIJSPA Q LAND USE APPLICATION SITE=S SE yrlc_ O PUBLIC WATER 'YSTEM OTHER (PL[ASE SPECIFY ABOvE) t t.)EI.t.c 1. List up to ten addresses in the space above. Select the type($) of files from the list above by checking the appropriate box(es). At least one file type MUST be selected. ax to 209 464-0138 or mail to the address indicated alcove. 2. EFID will notify the applicant If any EHO files exist. An appointment for review will be confirmed approximately five business days but no later than ten (10) days after receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled` accordingly. 3. A file that is actively being worked on by EHD staff may not be Immediately available for review. A now application may be submitted when the file is available. 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant. Future file reviews by the same applicant may require a $78.00 deposit prior to review. S. 'TENTATIVE appointment dates must be confirmed with EHD staff. 6. Applications receiver{ after 3:00 pm will be processed the next business day. CONFIRMED APPOINTMENT DATE TIME DATE CONFIRMED _ PHONE FAX INITIALS REVIEWED YES NO REVIEW DATE EH 06 14 MOWN ... I InfJ UNDERGROUND TANK (UST) CLEANUP SITE (LOP) OTHER CLEANUP SITE (NON -LOP) UNDERGROUND YANK (MONITORINGIREMOVAL) RAZARDOUS NYASTE GENERATOR 0 TIERED PERMITTED FACILITY �n q ❑ TATTOOiBODY PEIRCING ❑ MEDICAL WASTE= FACIL17 Y I• ❑ HOU$ING A T ENT ❑ SOLID WASTE FACILfIY ❑ FOOD ACIL ❑ SOLID WASTE VEHICLE DOG EL ❑ DAIRY S5'Tr=lJHOTEl_GK N RANC ❑ PICC TREATMENT PLANT d PUMPER TRUCKIYARDICHEM TOILETS Q POQIJSPA Q LAND USE APPLICATION SITE=S SE yrlc_ O PUBLIC WATER 'YSTEM OTHER (PL[ASE SPECIFY ABOvE) t t.)EI.t.c 1. List up to ten addresses in the space above. Select the type($) of files from the list above by checking the appropriate box(es). At least one file type MUST be selected. ax to 209 464-0138 or mail to the address indicated alcove. 2. EFID will notify the applicant If any EHO files exist. An appointment for review will be confirmed approximately five business days but no later than ten (10) days after receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled` accordingly. 3. A file that is actively being worked on by EHD staff may not be Immediately available for review. A now application may be submitted when the file is available. 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant. Future file reviews by the same applicant may require a $78.00 deposit prior to review. S. 'TENTATIVE appointment dates must be confirmed with EHD staff. 6. Applications receiver{ after 3:00 pm will be processed the next business day. CONFIRMED APPOINTMENT DATE TIME DATE CONFIRMED _ PHONE FAX INITIALS REVIEWED YES NO REVIEW DATE EH 06 14 MOWN ...