Laserfiche WebLink
ta. 209 3169 4228 'ch. 09 20M 09:079 illjNT-y _ <br /> j'QAll ii <br /> " ENVIRONlUI PUBLIC HEALTH SERVICES <br /> t= <br /> ENTAL H£ , <br /> 304 FAST WEBER HEALTH DIVISION <br /> AYENUE,THIRD fl_ODR <br /> STOCKTON CA o520y <br /> (209)468.3420 <br /> P.I'24CAdr <br /> PUBLIC RECQR03 RELEASE APPLICATION <br /> rn` <br /> ADDRE.,SS 2'� BUS/A/�-3S/A6ENh- <br /> � S <br /> PAC$N[LE <br /> 'EIJTATIVE`arPaur.MPsrr DAr� <br /> O'teas�W>,r 7 la 10 0yNyn r�kT�t�u n�ubmfn�ij EQ -9 2000 <br /> m CHECK BOX TO EJSPEDiTC Rrd"ET,3Ta00 Fly_ <br /> RataSIGNATURE OFuEsr PRocess>:D Id a auswsas Dors <br /> APPLICANT <br /> DATE <br /> FILE ADDRlyy l <br /> Y CQ <br /> -- r O <br /> �, 1di }Lr/ W� t-t57Ai p r <br /> �Ylk I <br /> 1 Ol <br /> ENVIRONMENTAL HEALTH�(S Cri Fill <br /> LrAN <br /> +���Qyv OT"UNOEti 31=1:)TANK( SITE(.oPJ D N0LiFooSlFACIllFM1IENY ❑ sO=WID AATE FACT <br /> y�HdALgRDpOUt41 TANK(►tDMTOR1dCiUtEhWYgL) C POOP}FAI,t(,irY `30tID WASTE FAL1L1 <br /> US ASTM Gaill�7Arpd DOG 1¢MNEL DAIRYVFill <br /> ❑ TM"-"FCtaafrreD FACUU_ r FANG" 0 <br /> 4 TATToOSCDy Pa1RCIN0 a 'MOTELM lim 13 PKO TIllil r,.r rl <br /> YEDICALWAgTE rACLlty O YOOtJ9PA ❑ PO4e`rRTAUCK—ARD"EMTpLEt,- <br /> O ?u6LIC WAT*.q sYsrQ�1 LANG USE APVLAC:ATiON s::Ps FEB 2 5 2000 <br /> t. Ust BJP fa ten aaprp6Lga in OTHER( SPECIFY AUCM <br /> thea ilio st Ono above. Select the types)of files from the Inst above b <br /> pPrnpriats hox(ss}_ At least anv Hto type t4tL)g7 hp seipctpd. x y checking <br /> to trd abovA 1<e SQ�491464�713__��,y evil to the <br /> 2. EHD Will notify the app1business <br /> it anyeLPIa �aApo3tttmant forrpvFew wUl hp canfititted <br /> Will o holdf y a maximn�s days bushill uTpaast d than ten aP days alter revel of a G <br /> wlti ba lipid for p2 pp cation. The fl!6% <br /> arr11J1 Urt of fYa farrgyi ) <br /> 3• A file 6IY 0i APPolntmEnts should be Schedulttl <br /> that[a nctivefy betng workptl or by El-lR etaff may rat be Gnrnud7afely avaUahte for rov;aw. Anew <br /> 4. apPllcatiar rncy be suUmltretl Wran:l,e flla is aVaUAble. <br /> Any fife mat returned in the Eamp condition as released will he reorUanj=aa b <br /> of the epFliw7t. Future Rlp reviews by Me same aPRlic wil may <br /> 5• t'rfATIVE p y EHD start at the expense <br /> 8' <br /> Applications <br /> recplvetl ant dates must lx wnfFmted with pop uitc a$78.00 deposit prnorto rovlew. <br /> after 3:00 pm will be Procesaed the next business day. <br /> CONFIRMED APPOINTMENT DATE <br /> DATF• CONFIR)i TAE <br /> I Pi10N[ <br /> REVIEWED FAX INITIALS <br /> REVIEW <br /> -�--�—.-- RATE <br /> I <br /> TOTfL P.©i <br /> DD -DQE-B ��-t� ura.o ., ol—ten a��o�. c,J���te={�.✓�xe_�. <br />