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07/08/2002 MON 12:50 FAX 916 5654356 R001/001 <br /> rJ r.I rJ01 trans Ors:4U abAJOAQUIN <br /> ENVIRONMENTAL TH PAGE 01 <br /> COUNTYPUBLIC HEALTH SERVICES q«;cooN�,soc <br /> ENVIRONMENTAL HEALTH DIVISION � <br /> 304 EAST WEBER AVENUE,THIRD PLOOh I <br /> STOCKTON CA 95302 <br /> 463-3420 <br /> PUBLIC RECORDS(209)RELEASE APPLICATION <br /> APPLICANT_ <br /> j--� HUSINESsrACeNcw .cH,au1 �-.��✓�2d.���r.�-,� <br /> ADI]REss / <br /> PHONE <br /> PACSIMILE <br /> n TENTATIVE;APPOINTMCNT DATE <br /> O--, (Please give T t i TIME <br /> s d 8PPt1 submittal) <br /> 'n <br /> CHA.CK BOX TO EXpEDrM REQUEST- <br /> SIGN ,.00F <br /> '-' - QU ST OCE I ] (NESS RAYS . <br /> ,�(�UREr 4F APPLICANT -• <br /> DATE oL <br /> FILE ADDRESS THIS SIDE CHID STAFF Use ONLY <br /> \, PROGRAM ELEMENTS SEARCH <br /> vendi �Z <br /> ``vvv w <br /> 5 <br /> �� <br /> Air a <br /> ENVIRONMENTAL HEALTH DIVISION FILE$ <br /> of UNDERGROUND TANK(UST)CLEANUP$)TE(LOP) r.1 HOUSING ABATEMENT d SOLID WASTE FAG11,nY <br /> ❑ OTHER CIEANUP s)Tl~(NON-Lop) ® FOOD FACILITY' ❑ S4UD WASTE VEHICLE <br /> a UND%RGROUND TANK PAONITOWNGIRemovAL) 0 DOC KENNEL ❑ DAIRY <br /> 10 HAZARDOUS WASTE GENERATOR d CHICKEN RANCH O PKG TREATMENT PLANT <br /> 13 TATTO PERMITTED oopIC[NoFAcITY t7 MOTELJHOTEL d PUMPER TRUGK/YAROICHEM Toll-M ,• <br /> ❑ MEDICAL oAv PCIRGILn Cl POq�PA C3 LAND USE APPLICATION SrrES <br /> t7 MEDICAL WASTE FACrLrrr D PUBLIC wA11GR sysTEM o OTHER(PLEASE SPECIFY ABOVE) <br /> 4. List up to tort addresses in the space above. Select the type(a)of files fmm the list above by checking <br /> the appropriate box(es). At least 0114 file type MUST lye selected. Fax to 209 464-0138 or mall to the <br /> address indicated above <br /> z- EHD Will notify the applicant if any EHD files exist, An appointment for review will be confirmad <br /> approximately five business days but no later than ten(10)days after rocelpt of application. The files <br /> will be held for a maximum of five businoss days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be Immediately available for review. A new <br /> application may be submitted when the file is available, <br /> 4. Any file not returned in the sante Condition AS released will be reorganized by EHD staff at the expense <br /> Of the applicant. Future file reviews by the same applicant tnay require a$89.00 deposit prior to review, <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> .6. Applications received after 3:00 pit will.be processed the next business day, <br /> CONFIRMED APPOINTMENT DATE, 'GIME <br /> DATE CONFIRMED PHONE FAX -INITIALS <br /> REVIEWE,13 YES NO— ftEVlEY1/ <br /> •enurnr <br /> Post-ie Fax Note 7671 °a�7 rZ. �� ,► <br /> To From <br /> . <br /> co maps. <br /> Phare k f'110ho R y Si_ �r� <br />