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-ULtU ]_:.IpL'I'1 i <br />SAN J(.-. JUIN COUNTYPUBUC HEALTH SEFimw..ES RRe ddd <br />G� O D ENVIRONMENTAL HEALTH DIVISION JAN 14 2000 <br />304 EAST WEBER AVENUE, THIRD FLOOR <br />sTOCKTON CA 95202 %NViNONMEN FA -1 HEALTH <br />(209)468-3420 <br />C PUBLIC RECORDS RELEASE APPLICATION PERMIT / SERVICES <br />APPLICANT � BUSINESWAGENCY __�I�1\ 'fly ` '�t�L { `�� t•¢n TJiC• <br />ADDRESS L --i <br />PHONE "1 L�O�W7 FACSIMILE <br />TENTATIVE'APPOINTMEMI)ATE____- — TIME <br />(Pb»e p'rvc 7 to 40 beaineaa dayr frau date of application su6mdtal�� <br />CHECK BOX TO EXPEDITE REQUEST - ]7e.W FEF –REQUEST PrtOCESS..EiiD--IN 7 USINESS OAY5 <br />SIGNATURE OF APPLICANT�,i,-� DATE. f GOOD <br />FREADORESS <br />ENVIRONMENI'AL HEALTH DIVISION FILES 1-26-00 <br />KluiERGROUNO TANK (UST) CLEANUP SITE (LOP) 0 HOUSING ABATEMENT ❑ SOLID WASTE FACiLIrf <br />0 OTHER CLEANUP SITE (NON -LOP) D FOOD FAoLFTY O SOLD WASTE VEHICLE <br />Ii NOERGROUNOTANK(l mFTORINGJREMOVAL) 0 DOG KENNEL 0 DAIRY <br />�-HA7AR000S WASTE GENERATOR O CHICKEN RANCH ❑ PKG TREATMENT PLANT <br />0 77EP.EO PERlarrrED FACILITY 0 NOTEUIIOTEL 0 PUMPER TRUCKIYARLNCRkM TOP ETS <br />0 TATTOORODY PEIRCING O POOLJSPA 0 LAND USE APPLICATION SITES <br />0 MEO(CAL WASTE FACiLITY 0 PUBLICWATERSYSTEM 0 OTHER(PLEASE SPECIFY ABOVE) <br />1. List up to ten addresses In the space above. Select the typo(s) of files from the list above by checking <br />the appropriate box(es). At least one file type MUST be selected. E4x to (?0% 4W-0138 or maJ to the <br />addressindicated above. <br />2. END will notify the applicant If any EHO flies exist. An appointment for review will be confirmed <br />approximately five buaine53 days but no later than ten (10) days after receipt of application. The files <br />Will be held fora maximum of five business days for review. Appointments should be scheduled <br />accordingly - <br />3. A file that is actively being worked on by EtiD 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 retumed in the same condition as released will be reorganized by EHO staff at the expense <br />of the applIcant. Future file reviews by the same applicant may require a ST8.00 deposit prior to review. <br />5. 'iE1YTATIVE appointment dates must be confirmed with EHD staff. <br />6. Applications received after 3:00 pm will be processed the next business day. <br />D <br />CONFIRMED APPOINTMENT DATE TIME <br />DATE CONFIRMED _ PHONE rAx INITIALS <br />REVIEWED YES NO REVIEW DATE <br />w w .+ F•WiW I <br />TOTAL P.02 <br />�i� <br />rI <br />n�nnirii <br />.�...I..fill" <br />ENVIRONMENI'AL HEALTH DIVISION FILES 1-26-00 <br />KluiERGROUNO TANK (UST) CLEANUP SITE (LOP) 0 HOUSING ABATEMENT ❑ SOLID WASTE FACiLIrf <br />0 OTHER CLEANUP SITE (NON -LOP) D FOOD FAoLFTY O SOLD WASTE VEHICLE <br />Ii NOERGROUNOTANK(l mFTORINGJREMOVAL) 0 DOG KENNEL 0 DAIRY <br />�-HA7AR000S WASTE GENERATOR O CHICKEN RANCH ❑ PKG TREATMENT PLANT <br />0 77EP.EO PERlarrrED FACILITY 0 NOTEUIIOTEL 0 PUMPER TRUCKIYARLNCRkM TOP ETS <br />0 TATTOORODY PEIRCING O POOLJSPA 0 LAND USE APPLICATION SITES <br />0 MEO(CAL WASTE FACiLITY 0 PUBLICWATERSYSTEM 0 OTHER(PLEASE SPECIFY ABOVE) <br />1. List up to ten addresses In the space above. Select the typo(s) of files from the list above by checking <br />the appropriate box(es). At least one file type MUST be selected. E4x to (?0% 4W-0138 or maJ to the <br />addressindicated above. <br />2. END will notify the applicant If any EHO flies exist. An appointment for review will be confirmed <br />approximately five buaine53 days but no later than ten (10) days after receipt of application. The files <br />Will be held fora maximum of five business days for review. Appointments should be scheduled <br />accordingly - <br />3. A file that is actively being worked on by EtiD 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 retumed in the same condition as released will be reorganized by EHO staff at the expense <br />of the applIcant. Future file reviews by the same applicant may require a ST8.00 deposit prior to review. <br />5. 'iE1YTATIVE appointment dates must be confirmed with EHD staff. <br />6. Applications received after 3:00 pm will be processed the next business day. <br />D <br />CONFIRMED APPOINTMENT DATE TIME <br />DATE CONFIRMED _ PHONE rAx INITIALS <br />REVIEWED YES NO REVIEW DATE <br />w w .+ F•WiW I <br />TOTAL P.02 <br />