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OS/�T/2�03 .13:28 '1 .,464013EJ ENVIRONMENTAL FEII PACE 01 <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> F`8 0 G 2003 ENVIRONMENTAL HEALTH DIVISION <br /> v 304 EAST <br /> "FOE AVENUE,THIttD FLO01't <br /> STOCKTON CA 95262 <br /> F ' (209)468.3420 <br /> PUBLIC RECORDS RELEASE�APPLICATION <br /> APPI pNT 55�q Y1�4 ot,e <br /> f BUSINESSIAOENCY <br /> ADD <br /> Rs <br /> PHONE IE$!Colo- 337 12(o <br /> - cA(!S(MILE_ 6.1 0 - 33'I - ').,1 it 9 <br /> TtZNYATIVE*APPOINTMENTDATE Y3�o3 <br /> (Plcase phy r to 10 bwl sa daya from Wt[o of+pplicallon sWun1�'Ilal)'� <br /> CHECK BOX TO E)GPEDtTE REQUEST $89.40 FEE— <br /> REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> *SIGNA7RE OF APPLICANT 1441 <br /> DATE <br /> FlLE ADDRESS 1r THIS SIDE ERR STAFF VSC ONLY i <br /> PROGRAM ELGMENTS SEARCH <br /> 1 _ F <br /> Is 7e' . <br /> + I T� <br /> O CI war d Z , y r; <br /> I T q <br /> 1 <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> ASI 0 RGROUNP TANK(OST)CLEANUP 517E(LOP) 0 nOUSD(G ABATEMENT If O SOLID WASTE FACILITY <br /> l GYNE CLEANUP SITE MONq.OP) 0 FOOD FACILITY tl 50L10 WAST@ VEHICLE <br /> jIC UNbRGROUNq YANK(HONrrORWG/REMOV/LL,) 0 DDG KERNEL IP 0 DAIRT <br /> J'IIAtJ1)tDOUSWASTE GENERATOR Cl CHICKEN RANCH I 0 PRO TREATMENT PLANT <br /> Q YM-RP PERMITTED FACILITY tl MOTELMOTEL 0 PUMPER TRUCKlYAROICMEM YOIL9Ts <br /> 0 TATt"MODY PE1RCa1G 0 POOLr-PA 0 LAM USE APPLICATION SITES <br /> 17 NEW WASTE FACILITY 0 OTHER(P1.EA5F SPECIFY ABOVE) <br /> 1. List up to ton addresses In the space above. Select the typos) of fetes from the list above by Checking <br /> the appropriate'boX(Cs), At least one filo typo MUST be selected. Fax to(209)464.0138 or mail to the <br /> address indicated at�va. <br /> Z• EHE)will no <br /> the applicant if sany'EHD file's exist. An appointment for review wil)be Confirmed <br /> approximately five business days but no later than ton-(10)days after receipt of application. The rites t <br /> will be held for a maximum of five business days for review, Appointments should be scheduled I <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 besubmitted when the file is available. <br /> 4. Any file not returned ift the same condition as•relcasod will be reorganized by EHO staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a$09.00 deposit prior to review. I <br /> 5. TENTATIVE appointment dates must be confirmed with END staff. <br /> U. Applications received altar 3:00 pm will be pr4eessgd the next business day. <br /> Post-ir Fax Note .i 767t Das I-• pep„r► <br /> CONFIRMED APPOINTMENT DATE, ToYin <br /> Fenn <br /> LDAT_ 'ONFIRMED ColDepf cw <br /> r Ph" <br /> REVikt(VED YES NO szp6)p Fera ! <br /> Z00/Z00'd 196TO Ii3NI31do San 6DTZLECO19 0:91 E00Z.90'933 <br /> rf 111 <br />