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F�'L-Ili Geo-Pha�� En .rLrunnt.dl ' ��. FN: NCi. =�c+`;69��'�15 Vic <br /> 4.. -GULi U2'161'19 <br /> 1i3-19-2PrGd '4:52W1 f TG 5G90295 P.02 <br /> Fol 'C) SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES t+w6Wnwwj.n <br /> ENVIRONMENTAL.HEALTH DIVISION <br /> OCT 2 5 2000 3114 EAST WIESER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95242 <br /> ENVIRONMENT HEALTHPUSLIC RECOW SsREE° <br /> RELEASE APPLICATION <br /> P r— <br /> r , r aUSINES&AQLUCYGCo AW,2Lx, <br /> - w e iC+e al-h dee <br /> FACSIULE <br /> v� TF-KTATIV1E`APPOINT1W.NT DATE •rine <br /> (Plaisa 21V4 7 W 10 buairlasa days 1-M data of applrcatran t4lun&�t <br /> CHECK BOXTO EXPUrrE REQURST-587.eG FE-REQUEST PROCEGS 3 8USNESS GAYS <br /> SIGNATURE OF APPLICANT DATE /d <br /> Y FILE:ADDRESS -1816 rAD11 END ST OS ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> 131 <br /> i <br /> a <br /> e<- G or TCr <br /> l <br /> ' 1 <br /> F-NYARONMENTAL HEALTH D1V151QN FILES <br /> UMDERGROUND TANK LU"CLLANUP 5rrE(LOP) r3 HOUSING A.8ATW&NT C1 30LID WASTE rACILITY <br /> OTliER GLFIWUP W9(NON•LQP) 0 FOOD FACILITY a SOLID WASTa VEHICLE <br /> $f UNDSIGROUND TANK(M0iUTcmmGlREMOVAt.) ❑ DOO KENNEL 17 DAIRY <br /> HAZARDOUS WASTE GENERATOR O CHICKEN RANCH la PKG TREATALENTPLANT <br /> B nERED PERMFI-Mb FACILITY O MOT&-UKC'T5L 0 PUNPIER TRUGMARWCHE M TQIL> rS <br /> Q TATTO"ODY PEIRCiKG 0 PdOUSPA; ' • ❑ LAND USI:AMUCA71ON SITES <br /> Q MENCAL WASTE FAC(UTY ❑ PUBLIC WAIMR SY5TEN ❑ OTHER( "OM SPECIFY ABOVE) <br /> List up to tan addresser,In tha sp0" above. SOICct the type{s)of files from the Ilst above by Checking <br /> i the appropriate boxes). At least OnO filo type MUST be selected, FaX tv2 <br /> jr -09)4M:9136 ol;mail To the, <br /> to <br /> �• EHD wl"netlfy the 2pP1lC$LMt It any EKD FUas exist An appointment for revleuv wnt be canitrrri4d <br /> approximately five busin$6s drys but no later than ten(10)days after recelpt of*pplts:atiOn. The tiles <br /> wilt ba held for a rneximUM of five business days for noview. Appointments shvald be scheduled <br /> sccardir<gly. <br /> • A file that Is actively being worked on by EHD staff may tivt be irnmadiatsly available for review. A neer <br /> I appllcatlort may be submitted when the 1116 IS available. <br /> d. Any file_n0t returned in tho same conditlari ns released will be reorganized by EHO staff at the exp4dse ..� <br /> of the applicant, Future file reviews by the same applicant may require R$87.00 deposit prior to r9Yl@w. <br /> 5. 'TENTATIVE appointment dater must ba cenflrmed With EI-it)staff. <br /> �. Applications received after 3;00 pm Will be praeassed the next bu3inGSs day. <br /> CONFIRMED APP01trFMENTDATEj Time <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> LAFWEVVED Yl=S NO REVIEW DATE <br /> u duo _ <br /> s ,* <br /> TOTAL- P.03 <br />