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09 19-2000 10:21AI FRUM 1 END LOC NUMBER <br /> (u errv® <br /> I' olir AN JOACMN COUNTYPUBLIC HEALTH SERV16-4 <br /> ENVIRONMENTAL HEALTH DIVISION f� <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> FEB 2 j ZU01 STOCKTONCA95202 <br /> (209)4883420 <br /> Et!UIFC!f,Iti ' ,�i FUBLIC RECORDS RELEASIT- APPLICATION <br /> W <br /> APPLICANTMikelren , BUSINESSIAGENCY�Hen�heW Associates, Inc. _ <br /> �DDRess 11875 Dublin Svd,rYSuite A-200, Dublin, C/A 94568!�� <br /> HONE �� �~ / r ! 4 r_�FAGSIMLLE •` 55,1 ~ `741 <br /> • <br /> TBMT/lT1VEIAPPOINTMENTDATE.�/t/Q� -TIME �•0 4M rr�� <br /> `. (Pleas*Dlve I la 10 bUsinllt�]/8 rrefp fldU Ti apPlt6at(On submittal L LI/V <br /> PCHECK BOX TO EXPEDITE REQUEST-$87.00 FLEE—RE BT PR ESSEIIINIDUSINESS DAYB 7 <br /> SIGNATURE OF APPLICANT�Lr --;y DATE o�'J <br /> I <br /> FILE ADDRESS THIS SIDE Elio STAFF USE ONLY <br /> PROGRAM ELEMENTS eEARCH <br /> NOF I 5 <br /> rY [aVITT 773U, O <br /> 1 <br /> trr 1 <br /> f na <br /> ENVIRONMENTAL HEALTH DIASIONFILES FEB 28 <br /> }I UNDERGROUND TANK(UST)CLEANUPSITE(LOP) Cl HOUSING ADAn:MEI IT 0 SOLID WASTE FACILITY <br /> Ty�Ad OTHER CLEANUP SITS(NON-LOP) 13 FOOD FACIUTY 0 SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITOPUN0JREMOVAL) O DOD KENNEL 0 DAIRY <br /> HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 0 PKD TREATMENT PLANT, <br /> 0 TIERED PERMITTED FACILITY 0 MOTEUNOT£L 0 PUMPER TRUCKNARDICHEM TOILETS <br /> C3 TATTODIBODY PEIRCING ❑ POOLWA O LAND USE APPLICATION SITES <br /> 0 MBOICAL WASTE FACILITY 0 PUBLIC WATERSYS` EM 0 OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses In the space above. Selact the type(s) of files from the list above by Checking <br /> the appropriate box(es). At toast one filo typo MUST be ;elected. Fax to(20914154-0139 or mall tq the <br /> ad rasa Indirsigd above. <br /> 2. EHD will notify the applicant if any EHO 17105 exist. An a 3poinlment for review will be confirmed <br /> approximately five business days but no later than Gln(10)days after rocelpt of application. The files <br /> will be hold for a maximum of five business days for rev ow. Appointments should be scheduled <br /> accordingly, <br /> 3. A file that is actively being worked on by EKD staff may not be Immediately available for review, A new <br /> appliealton may be submitted when the file Is available, <br /> 4. Any fife not returned in the same condition as released•vill be reorganized by EHD staff at the expense <br /> Of the applicant. Future fire reviews by the same apPltel nt may require a $87.00 deposit prior to review. <br /> 9. 'TENTATIVE appointment dates must be confirmed Ivith EHD staff. <br /> s. Applications received after 3:00 pm will be processed 0a next business day. <br /> hONFIRME D APPOINTMENT DATE TIME <br /> ATE CONFIRMED PHONE FAX INITIALS <br /> EVIEWED YES NO REVIEW DATE <br /> n m fs ownao <br /> I <br /> TOTr1L-P.01 <br />