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SAN �QUIN COUNTYPU13LIC HEALTH �2VJCES � 1 <br /> ENVIRONMENTAL HEALTH DIVISfON l <br /> 304 EAST WEBZR AVENUE,THIRD FLOOR 52 <br /> Nov.;1 5 2000 $TOCKTON CA 95202 <br /> (209)488-3420 •Z iB0 <br /> ENVIRONMENT HEALTH PUBLIC RFzCORDS RELEAS1` AP IC 1ON <br /> PERM�P/P Nr ' <br /> $IJS1N$SSfAGENGY <br /> RHONE ( f C� r� Y T L FAC51DSlLE i 1l 0— " C <br /> TENTA'T'IVE•APPOINTMENT DAT$_ My _ C..F TIME tJ J <br /> (Pio?Fo ptuq 7 to to buvinvas days from d;lto of application vubrrAttul) <br /> CHECK BOX TO EXPEUr rE REQUlr57 o F — OCESSED IN 3 BUSINESS DAYS <br /> SiGNA7Ul2E OF APPLICANT <br /> DATE // <br /> FILEADDRFSS THIS SIDI;EHO STAFF u3E ONLY <br /> PROGRAM ELEMEr"9 S"RCII <br /> Al. R 3s Z-7 <br /> 1� -- <br /> ENVIRQ MENTAL HEALTH DIVISION FILES <br /> V24NbERGROUND TANK(1JS-0 CLZmUP SITE(LOP] 0 HOUSING ABATEMENT 0 SOLID WASTE FACILITY <br /> 0 OTHER CLEANUP 517E(NON-LAP) ❑ FOOD FACILITY 0 SOLID WASTE VEMICLE <br /> C7 UUDERGROUND TANK(MDN1T0RINa1REA10VAQ 0 DOG KENNEL In DAIRY <br /> -k94i 12ARDOUS wA;i7E nExErtATcm 0 CHICREN RANCH 0 PKO TRE ATNEM'PLANT <br /> �7 TIERED PERM[17ED FACILITY 0 MO1'LIJHOTEL o PumpekTRu-_KfyAR="EM7piLETs <br /> n TATTOO1500Y PORCMU 0 I'aOLJSPA - 0 LAND USE APPLICATION SrTrZ <br /> 0 MEDICAL WASTE PACU_" '❑ PU13LIC WRTk"K SYSTEM ❑ OTRZR(PL.EASI!SPPCIFYABOVE) <br /> '�. List LIP to ten addresses In the space above. Select thea-type(s) of Tiles from the list above by checking <br /> the appropriate boxes). At least one file type MUST be selected, Fax to 209)464-0138 or mail to the <br /> address indi"ted above <br /> 2. EHD wilt notify the applicant if any EHD files exist_ An appointment for review will,be confirmed <br /> approximately flue busiftess clays but no later than ten(10)days after receipt of application.-The flies <br /> will tie held for a mazimurn of five business days for review. Apptslntmorits should be srtladuled <br /> accordfngly, <br /> S. A file that is actively being worked on by END staff may not.be immediately available for review. A new <br /> aFplication may be submitted when the file is available. <br /> 4. Any file not returned in the carne conditlon as released vrill be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the same appilea,nt may require a$87.00 40POsit Friar to review. <br /> 5_ 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6, Applications received after 3:00 pm will be processed the next business day. <br /> j <br /> OONFIRMED APPoIi~wENT CATS TIME <br /> DATE CC1IdFtRMEGt PHONE FAY( INITIAL$ <br /> �EVIEWED YES NO REVIEW DATE . <br /> pi M 14 04wm <br /> TOTAL P.02 <br />