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09/15/2005 10:53 530676606 STRATUS NO CALIF PAGE 01/01 <br /> @gvIROWENTAL HEALTH PAGE 01 <br /> (0055/11/2804 14:50 4640138 tnu LVU NUMOCR <br /> �vL'1 SAN JOAQUIN COUNTY <br /> FiNVMONM-FNTAL HEALTH DEPARTMENT <br /> 5Et 15 <br /> L005 304 E Weber Ave 3'd Floor Stockton,CA 95205 Da usrehd <br /> EI�ViROPlfer.FNT HEALTH (209) 460420 Fax: (209)464-0138 Web:wv/t"'.co.san-joagt» <br /> pmi�^'msI R\ IM 'PUBLIC RECD ;R: S RELEASE III,ICA'ITON <br /> �) �S v!m <br /> APPucrwT: <br /> S s 13lffl �l 13USINFS3lAGENCY.� j CA Z <br /> �ApDRESS: f N FACSP41LF: <br /> HONE: �0?6-206 <br /> Time:�._---- <br /> TENTATM1+> `APPOINTMENTDATE: <br /> (P16a'se allow 70 bUSine%s days from date of 101cation e!lbmlttal) <br /> ❑ CHECKDOXTO Exp,,,,,,,IIULST-S93.00FEE- REQUESTPROCESSEDIN3BUSINESS DADATE <br /> SIGNATURE OF APPLICANT D=panment Use Only <br /> U9LUNRI <br /> FILE ADDRESS - I � <br /> I p unit 2 <br /> a <br /> ° s°'" ❑ nit 3 <br /> Unit 4 <br /> e. Skeet <br /> T ❑ Unit 5 <br /> a o <br /> !d. S�I <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> C3HOUSING ABATEMENT <br /> c3 SOLID WASTE FACILITY <br /> 0 SOLID <br /> CLEANUP SFM tLOF) FOOD FACILITY <br /> UNDERGROUND TAW,(UST) t7 O DAIRY WASTE VEHICLE �! <br /> OTHER CLEANUP$ITE(NONRORINGIREMOVAL) Z] DOG KENNEL ❑ PKG TRFATMSI17 PLANT 4S'' <br /> ❑ UNDEROROUND TANK(M 1:3 CHICKEN RANCH 0 puMPFR TRUCK/YARDICHEM TOILETS <br /> ' ' ❑ HAFARDOUS WASTF G5 mTOR G+ MOTRRIOTEL p LAND U5'E APPLICP.'nON SIMS*' Cl TIERED PERAUm TT ❑ PDOI.ISPA <br /> 0 TA1700711OOY PtERC1NG M OTHER(PLEASE SPECIFY) <br /> MEDICAL WASTE FAc1LITl' m the fist above by checking <br /> of files from <br /> Dx es At least One fife type MUST be selected. Fax to 2(18 -0138 or mail to the <br /> List up to ten addresses in the space above. Select the"(s) <br /> the appropriate b ( 1• <br /> address indica above, An appointment for review f a be confirmed <br /> EHE)W ill nonoi�ify the applicant If any EHD files exist )da �r receipt of application. The fates <br /> 2. Appointments should be scheduled <br /> approximately five business days but no later than ton ss days for review. <br /> ie Ys <br /> will be held for a maximum of five bust" EHD staff maylnothe Immediately available for review. A new <br /> accordingly. on by <br /> 3_ Afile that is actively baing workmen the file is available. EHD stat{at the expense <br /> application maybe submitted a require a$43.0(1 deposit prior to review. <br /> 64 <br /> 4. Any fi10 not returned in the same conditionyhe samet appliCantl may req reorganized Y <br /> of the applicant future file review's by with EHD staff. <br /> 'TENTATIVE appointment dates mrus`t be c nl ll be rmel the next business day. <br /> 5' hcattons receSved atter 3:00 p <br /> S. APP TIME <br /> 1hQ <br /> FIRMED APPDtN?MEPfT DATE 1NfTTAIS — -- — <br /> PHONE FAX <br /> DATE CONFIRM! 0 REVIEW DATE <br /> EvyEDYESza <br /> 6.xzT.] <br />