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07/08/2002 MON 12:50 FAX 916 5654356 001/001 <br /> ��rr r�ur tnn,� IU:Ott 4b4a 10 - ENVIRONMENTAL VVV TH PAGE P 1 <br /> ;J1 JOAQUIN OOUNTYPUBLIC HEALTH FtvICEs gmrc toot � <br /> 1=NVIRONMENTAL HEALTH ralvlSiON <br /> 304 EAST WESER AVENUE,THIRD PLOoR ' <br /> STOCKTON CA 95202 -00 <br /> 4BB-3420 711 <br /> PUBLIC RECORDS9RELEASE APPLICA11ON <br /> At'PLICANT : y� <br /> l`_� r�.c1 HUSINeswAGeNGY <br /> ACSIMILE <br /> aTENTATIVE*App01NTMC. <br /> DATE <br /> C^, (Please give 7 t iTIM[ <br /> s d aFlul submittal) <br /> I <br /> CHECK(10X To EXPEDIM REQUEST- ,Od F _ <br /> '--' QU ST OCE p 3 tNESS DAYS <br /> sIGNNT')RE OF APPLICANT _. <br /> G DATE c+L <br /> Fly ADDRESS THIS SIDE EHO STAFF USe ONLY <br /> PROGRAM ELIVARNTS SEARCH <br /> L ! Z <br /> V N <br /> \`vvV W <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> ill; UNDERGROUND TANK(UST)CLEANUP SITE(LAP) ® HOUSING A13ATEMENT 0 SOLID WASTE FACILITY <br /> ❑ OTHER CLEANUP SITE(NON-LOP) O FOOD p:AC1LrrY ❑ <br /> (3UNDCRGROUND TANK(MONITORiNG/RemovAL) CI DOG KENNEL CI DA RAY WASTE VEHICLE <br /> 0 HAZARDOUS WASTE GENERATOR d CHICKEN RANCH D PKG TREATMENT PLANT <br /> CI TIERCO PERMITTED FAcii rrY D MOTELJHQTEL [7 PUMPER TRUC: YARD/CHEM TOILETS ' <br /> ❑ TATYOQeoODY FORCING ❑ PgppMP,q Q LAND USE APPLICATION SITE M <br /> ❑ MEDICAL WASTE FACiLrrY D PUBLIC WA=�R SYSTEM o OTHER(PLEASE SPECIFY ABOVE) <br /> 1, List up to ten addresses in the space above. Select the tyPe(S)of 11105 from the list above by checking <br /> the appropriate bOX(es). At least ono file type MUST be selected. Fax to 2D9 464-0138 or mall to the <br /> address indicated above_ <br /> Z- EHD will notify the applicant if any EHD flies exist. An appointment for review will be confirmed <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 business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A tele 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 settle 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$89,00 deposit prior to review, <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 APPOINTMENT DATE. 'GIME <br /> DATE CONFIRMED PHONE FAX •INITIALS <br /> Rl'_VIEWC-0 YES NO fZEV1ELV DA'C�,•.. <br /> Post-ie Fax Note 7677 0-ta7 r'?-- �� ,► <br /> Ta F[orn • <br /> A <br /> Co1Dapt <br /> Phone# Ftww re-7 G �Vf- Z v <br /> cwd i•.rf- r. "' lJ ?w�.f� Fax/ Zo 1 ��l/ ! f <br />