Laserfiche WebLink
@4/07/26IR[ 4(� ] TB i AGE STOCKTON PAGE 01/01 <br /> L 1i 9No LOG Huksew <br /> � C;�UIN COUNTYPUBLIC HEA $ <br /> LTH SL-DICES <br /> APR [i 7' 203 ENVIRONMENTAL HEALTH DIITISIOTI <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> ENVIRONMENT HEALTH STOCKTON CA 85202 <br /> 468-3420 <br /> PERMiT/SERVp5€fl3L1C RECORDS(209)RELEASE APPLICATION 3c <br /> APPLICANT BUSINESSIAGENCYd }�7QI� �r ,p�ZQ <br /> ADDRESS h �� �!FACSIMIL�E <br /> PHONE <br /> TENTATIVE*APPOINTMENT DATE'' TIME <br /> _ I ) <br /> (Please dive T to 10 husiresa days from data F application submittal) L~[O+ 3 <br /> CHECK BOX TO EXPEDITE REQU T-$91,00 FEE–REQUEST ROCESSED IN 3 BUSINESS DAYS, � • <br /> SIGNATURE OF APPLICANT ¢ <br /> DATE ! �� <br /> FILE ADDRESS —_ I <br /> rt UP r a <br /> RJR <br /> Ado <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK{UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT © SOLID WASTE I-ACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL 13 DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> {7 TIERED PERMITTED FACILITY C3 M01ELIHOTEL ❑ PUMPER TRUCKIYARD/CHEM TOILETS <br /> O TATT00II3ODY PEIRCING ❑ POOVSPA 0 LAND USE APPLICATION Bill <br /> ❑ MEDICAL WASTE FACILITY ❑ PVI3LIC WATER SYSTF_M ❑ OTHER(PLEAS€SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above. Select the type(s) of files rrorrl the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax.to (208)464-0138 or rill to the <br /> address indicated above. <br /> 2. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10)days after recript of application. The files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> F <br /> 3. A file that is actively being worked on by EHD staff may not be Immediately available for rev{ew. A naw <br /> application may be submitted when the file is available. i <br /> 4. Any file not returned in the same 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 $78.00 dupo toft <br /> 5. `TENTATIVE appointment dates must be confirmed with EHD staff. e; <br /> 6. Applications received after 3:00 pm will be processed the next business clay. ct •� i I <br /> CONFIRMED-APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> am 09 14 9110=0 <br />