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_ . _ _ ___. _._-._.. <br />09-04-2001 11:3E3R1 FR3M • <br />--SAN JOAQUIN COUNTYPUBLIG HEALTH SERViCI=S <br />ENVIRONMENTAL HEALTH DIVISION <br />1 344 EAST WEBER AVENUE, THIRD FLOOR <br />STOCKTON CA 95202 <br />(209) 468-3420 <br />uBLjC RECORDS RELEASE APP .iCATI0N <br />'APFU ANT_ <br />ADDRLS <br />LIIV IA— Ilul.iull� <br />i <br />kb; ��tM U�1 So.N auswa;ss�A��rtcY �t aS <br />z A2 MO�A T <br />LJ�LIA�(z{J I SuITE (OC::) <br />F1ioHrt tlt{ S0 UDD FACSIMLa;_ (L4 i 5� $9�l -J LnD I ■' <br />I TENTATIVE' APP01NTME?�T DATE t Y1� � TIAM <br />II (Ploar,Q give �7 to 10 b�u�au mss d s from dAw of appllcaiian submittal) <br />GliECK SOX TO F4F" DrTF RE.QUES;r- SaT.00 FEE -• REQUEST PROCSSSEL% 1113 B1jS1t165:. BAYS <br />SIGN�,TURZ OF APPLICANT <br />DATE <br />FILE,X0-D E3S T1iIS S1DE Fe ND STAFF USE ONLY <br />PROGRAfA ELEMENTS 51 AKUH <br />2402A Soifr� CAL 1 FORN iA : ; IeEcT .. ! a <br />y� ((,, I l <br />> ..»nc�r1U PILES <br />UNLRGROUND TANK (UST) CLEF14.w- I rE (LOP) Ey NOU5ING A9ATEmENT 50LiD WASTE! FACILITY <br />OTi F -R CLEANUP 5>TE (MON-LOP) O FOOD FACTUTY SOLID WASTE VEHICLE <br />Utl F,ROROUND TANK (MONITORINGIRE:MOVAL) Q DOG KENNEL DAIRY <br />HA�Ap,DOUs V)ASTE G ENERAT012 0 CMCKEN RANCH PKG 1TiCATMENT PLANT <br />TICREOPERMITTED PACILrTY O MOTEUHOTEL PUMPER1RUCWYARERCNEMTG"TS <br />0 TAITOOMODY PEIRM5 0 POOLISPA LAND USfi APPLICATION SriES <br />a Mr 1CAL WASTE FAc1LrrY 0 PUBLIC WATER SYS iHOI 0 OTHER (PLEASE SPECIFYAELOVE) <br />i <br />1 _ List up to tots addresses in tho space above. Select the type(S) of fllds from the list above by checking <br />the appropriate box(es).: At feast one file typo'MUST be selected_ Fax to (209) 464•-0130 or mail to'the <br />� n dress ind_tcatet{ �hQ31�- <br />2 EHD wili notify the applicant if any EHD files exist_ An appointment for revlllvr will be confirmed <br />approximately flvo business days but no later than Wrl (10) days after receipt of application. -The Was <br />will be Feld for a maximum of five business days. for review. Appointments should be scheduled <br />accordingly, <br />3. A file that is actively being worked on by EHD *tuft may not bGt immediately avaiiak)le for review. A now <br />application may be subrAitted when the file is avallable. <br />4. i Any file not returned in the same condltion as released will be reorganized by EHD staff at the sxpenso <br />I of the applicant. Future f ile reviews by the same of plicznt may require a $537.00 deposit prior to review, <br />5. ! `TENTATIVE appointment dates must be confirmed with EHD staff. <br />6. ! Applicaltons received after 3:0U pm will be processed the next lausiness day. <br />.Co��IRMED 400IHTMENT DATE TIME <br />DAT6I CONFIRMED PHONE FA?( 1N(TIALS <br />I REVJEYY4D YES ' NO REVIEW DATE <br />F.H 00 u, .opro TOTAL P.01 <br />.d <br />2)LPI i4 <br />5� <br />A1PPc)P;r' <br />ar'Ic <br />Y-1�'1 <br />3yS <br />t r+ <br />r 3 <br />SouTt1 <br />F --L_ Qv <br />(S�iRf=ET -3s �(a 4K <br />- <br />2' IIZ <br />5a1LTtt <br />t_ <br />V <br />A �b STfLE� i <br />� I C9 <br />�ua'"T4-1 <br />EL. L�4(zA�o. �T�EET _ � �jS'�•�P _ <br />2402A Soifr� CAL 1 FORN iA : ; IeEcT .. ! a <br />y� ((,, I l <br />> ..»nc�r1U PILES <br />UNLRGROUND TANK (UST) CLEF14.w- I rE (LOP) Ey NOU5ING A9ATEmENT 50LiD WASTE! FACILITY <br />OTi F -R CLEANUP 5>TE (MON-LOP) O FOOD FACTUTY SOLID WASTE VEHICLE <br />Utl F,ROROUND TANK (MONITORINGIRE:MOVAL) Q DOG KENNEL DAIRY <br />HA�Ap,DOUs V)ASTE G ENERAT012 0 CMCKEN RANCH PKG 1TiCATMENT PLANT <br />TICREOPERMITTED PACILrTY O MOTEUHOTEL PUMPER1RUCWYARERCNEMTG"TS <br />0 TAITOOMODY PEIRM5 0 POOLISPA LAND USfi APPLICATION SriES <br />a Mr 1CAL WASTE FAc1LrrY 0 PUBLIC WATER SYS iHOI 0 OTHER (PLEASE SPECIFYAELOVE) <br />i <br />1 _ List up to tots addresses in tho space above. Select the type(S) of fllds from the list above by checking <br />the appropriate box(es).: At feast one file typo'MUST be selected_ Fax to (209) 464•-0130 or mail to'the <br />� n dress ind_tcatet{ �hQ31�- <br />2 EHD wili notify the applicant if any EHD files exist_ An appointment for revlllvr will be confirmed <br />approximately flvo business days but no later than Wrl (10) days after receipt of application. -The Was <br />will be Feld for a maximum of five business days. for review. Appointments should be scheduled <br />accordingly, <br />3. A file that is actively being worked on by EHD *tuft may not bGt immediately avaiiak)le for review. A now <br />application may be subrAitted when the file is avallable. <br />4. i Any file not returned in the same condltion as released will be reorganized by EHD staff at the sxpenso <br />I of the applicant. Future f ile reviews by the same of plicznt may require a $537.00 deposit prior to review, <br />5. ! `TENTATIVE appointment dates must be confirmed with EHD staff. <br />6. ! Applicaltons received after 3:0U pm will be processed the next lausiness day. <br />.Co��IRMED 400IHTMENT DATE TIME <br />DAT6I CONFIRMED PHONE FA?( 1N(TIALS <br />I REVJEYY4D YES ' NO REVIEW DATE <br />F.H 00 u, .opro TOTAL P.01 <br />.d <br />