Laserfiche WebLink
Mar 05 2004 1 : 06PM GEOLOGICR 14155977880 P_1 <br /> 83!0512804 11:52 4640 ENVIRONMENTAL STH PAGE 02 <br /> IFillC C ��2 L�Lei SAN JOAQUIN COUNTY <br /> ENMONMtNTAL HEALTH DEPARTMENT <br /> MAR 0 $ 2004 304 E Wcbcr Ave 3'd Floor Stockton,CA 95205 <br /> (209)468-3420 Fax: (209)464-0138 Web:WWW-COsanjoaquin.ca.us/chd <br /> I VHuNMENT HEALTH <br /> PUBLIC RECORDS RELEASF APPLICATION <br /> CAN <br /> APPLIT: i^ SUSINESSiAGENCY: eo C> <br /> ADDRESS: .ACC A l cj{- �r�G `4-0 Q <br /> PHONE: S ! �- FACSIMILE: <br /> p d Fs j <br /> TENTATIVE'APPo"FNTDATE: "j fS�04f Time:_ I alk <br /> (PNase show 18 b"IrOe a days Imm date a appocacoo tubm" <br /> CHECK 80X70 ExPEvrm REWES 113.o4 F UE PR E 1E-DAN 3 BUSINESS DAYS <br /> SIGNATURE Of APPLICANT € F <br /> DATE <br /> f3epaeh�w U/e Only <br /> FLLE ADDRESS - UNIT <br /> ' 3 e <br /> r Cft � vu\,A ❑ Unit <br /> f' aeew W V 11 <br /> 0. ah/I <br /> me+ o u Unll3 <br /> •. aaaei Unit 4 <br /> /. aveet <br /> lo. feeel q Unit 5 �- <br /> L�. <br /> J ENVIRONMENTAL.HEALTH DEPARTMENT FILES <br /> P UNOERGRWHD TANK(u5T)CLEANUP SITE(LOP) O HOUSING ABATEMENT ArSOMO WASTE FACILITY <br /> XOTHER C LEAHur anE(NONtoPi C1F000 FACILITY C3SOLIO WASTE VEHICLE <br /> t*MEROROUt`l') µ10H[.01M FMOVAL) 0 DOG KENNEL ❑ DAIRY <br /> NAZAROOUS WASTE GENERATOR ❑ CHICKEN RANCH - ❑ PK07RF_ATyEN7PWlT <br /> 0 TIERED PERMRTED FACiUTY 0 MOTELMOTEL ja`PUIlPER TRUCKKARIHCIiEM TOILETS <br /> 0 TA1T00100DY PIERCING ❑ POOLISPA 0 LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACxJTY n OTHER(PLEASE 8PE0IF`n <br /> 1. List up to ten addresses In the space above. Select the typo(s)of fit"from the list aboye by tha I <br /> the appropriate box(es). At bast one file type MUST be selected. Fax to(209)464-ous a m C to the <br /> address Indicate afwv - <br /> 2_ EHD will notify the applkant H any =HD files exlaL An appointment for review will be colHirmed <br /> approximately five business days but no later than len(10) days after receipt of application. The flies <br /> Will be held for a maldmum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that Is actively being worked on by EHD staff may not be immediately available for review. A new <br /> application may be submitted when the file Is available. <br /> 4. Any f.16 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$9100 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm WIN be processed the next business day. <br /> 4"FJOWN ,D.`@iP�bINT1Jtl Ni DATE.: '-. ` , . ' 7iMt +ii; ; <br /> S1%1f♦ CONFIRFAI±U _ PHONE FAX iNItIALS <br /> ltEV1EWED: of 'YEe NO REVIEW DATE <br /> •nn•a <br /> r•/ <br />