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9ATeRecelvCL) L!- <br /> Ir t/76-AN';JOA�'�'IINCOUNTYPUBLICHEAI - ttil)LOU"WWOER <br /> tH SER�JES <br /> E14-ARONMENTAL HEALTH DIVISION <br /> 304 EAST WESERTHIRD FLOOR <br /> APR 0 3 2003 STOCKTON CA 95202 <br /> 468-3420 <br /> i-AVIRONMEW[ fl[PUBLIC RECORDS(20)RELEASE APPLICATION <br /> APPLICANT <br /> SUSINEss/ArENCY EIA) &ntbj?,Qnf" <br /> 'f <br /> ADDRESS <br /> 4 <br /> �1�R,. -U <br /> PIiONIr FACSIMILE_. <br /> TENTATIVE*AP:'OINTMFNT DATE TimE -1&22Ayy0 <br /> (Please give 7 to 10 b--in-r-a days from data of appili:ation submitt;pq <br /> HICK BOX To EXpEDIT'REQUEST-$80.00 FP-r=-REQUEST PROCESSED IN 3 PiIJSINIESS DAYS <br /> SIGNATURE OF APPLICANT <br /> DATE2j-:.�-o <br /> -ILE ADDRESS THIS 31DE EME,STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> 12,Th <br /> -3 <br /> - h <br /> IF <br /> ENVIRONMENTAL HEALTH DIVISION PILES <br /> clUNDERGROUND TANK(US")CLEANUP SITE(LOP) 0 HOUSING ABATEMENT 0 SOLIII WASTE FACILITY <br /> -OTHER CLEANUP SITE(No 4-LOP) 0 FOOD FACILITY 0 SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(140 41TORINGfREMOVAL) 0 DOG KENNEL 0 DAJ8Y <br /> /101\HAZARDOUS WASTE GENE RATOR E3 CHICKEN RANCH 0 PK12 TREATMENT PLANT <br /> CI TIERED PERMITTED FACILI rY 0 MOTEWHOTEL 0 PumPER TRUCKIYARDICHEM TOILETS <br /> 0 TATT001000Y PEIRCIKG 0 POOUSFA - 0 LAND USE APPLICA11ION SITES <br /> 0 MEDICAL WASTE FACILITY 0 C3 oTnF-R IPLEASE SPECIFY ABOVE) <br /> 'l. List up to ten addresses in the space above. Select the typels I of files from the list above by checking <br /> the appropriate box(as). At least One 1`119 type MUST be seloctiid. Fax to 20,91464-0138 or mail to the <br /> address Indicatad above. <br /> Z. EHD will notify :he applicant if any EHD files txist- An appolwxnerlt for review will be confirmed <br /> approximately five business days but no later than ten(10) dabs after receipt of application. The files <br /> will be hold for a maximum of five business days for review. li,ppointments should be scheduled <br /> accordingly. <br /> 3, A file that is aclivety being worked on by EHD staff may not bit Irnmediately:available <br /> application may be submitted when the file is available. <br /> 4. Any file not rett irned In the same condition as released will be reorganized by EI-ID slaf;a <br /> of the applicant. Future rile reviews by the same applicant may require a 589.00 deposit prior to review. <br /> 5. -TENTATIVE aF pointment dates must be confirmed with EHCO Muff. <br /> 6- Applications re;eived after 3--00 pm will bo processed the nex:business day. <br /> -- <br /> CONFIRMED <br /> CONFIRMED APPOIN"MENT DATE TIME <br /> DATE CONFIRMED PHONE PANX IPIITIALS <br /> REVIEWED y I S NO REVIEW DATE <br /> 04/03/03 THIJ 13:20 [TX/RX NO 96021 Q002 <br />