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TO <br /> 1e-12-2000 b43:OGAM M <br /> •N.•J c 0.G VC1Y[ll <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICIM <br /> ENVIRONMENTAL HEALTH gIM110N �" <br /> 304 EAST WEBER AVENUE,T-1118 l FLOOR O C T <br /> STOCKTON CA 95202 2 2000 <br /> (2019)468.3420 IRONMENT HEA <br /> PUBLIC RECORDS RELEASE APPLICAT161. <br /> H <br /> APPLICANT_Y {' lyi�'�JCc _BUSINE1MA13ENCY . <br /> r 9s � <br /> Aopizgss <br /> TENTATIVE^rwPQ1I1TpAEPir DATE tio!a31 cx� VAL $ hal <br /> J (PI&ascr 9lva 7 to 1 D busirwas days Gam date of appl1ut1QA submitiel). <br /> CHEX;K BOX TO Expr_DiTr_RF_QuE3T-$07.00 PEE—R"VEST P 4CtsSED IN 3 BUSINESS DAYS <br /> J SIGNATIJRE of APPLICANT ���� ��'�_ f_—� �c � DAT>~ ro I a <br /> DRESS <br /> 19 SIDE EHD 97AFF USE ONLY <br /> PRodriAxu ELEMENTS SIGH <br /> (Y) <br /> I tea , P1k . k Sid <br /> Vo C I� <br /> p(a,,� <br /> 11-77, cenje <br /> psr_a rc� - S <br /> ENVIRONMENTAL hEALTH DIVISION FILES FA U Z <br /> uMDERGFL0UNDTANK(U$T)CLEANUP SITE(LUP) Q MOt)UING ARATEWW CI SOUR WASTE FACU.nY <br /> OTH>wR CLEANUP SITE(ROH-LOP) R FOOD FACILITY n SOLID WASTE VEHICLE <br /> KIE0 DAIRY <br /> UNDEXCROUNDTAKK(IgWTO2NWREMOVAL) M CHICKE14 RANCH D pKii <br /> T3TEAn4 !'1'C PLANT '• <br /> jolt I{A7ARUOV3 WASTE GI:NZRATOR 0 MoTELMOTEL ❑ PUMP6RTRUCWYAP.9IGMa 10 tLETs <br /> 0 TIL•RED PER.t MED FACKJTY ❑ p&XJSPA - ` 0 LAND USE APPLICATION 31t9 <br /> 0 TA-rTOONODY PEIRCING O PUBLIC WATER USTEM Q OYHER(PLEASE oPECWY <br /> C ME=At,WASTE FACILITY <br /> ft <br /> 1. List up to tan addresses In the space above, Select fha type(s�of Tiles from the 11st At�ove bar 1 �klnp <br /> the appropriate bnx(e�r). At least one MC typo MUST be selectad. Eax to(29M W-0 III ZN <br /> address Indit7at��}�Yg <br /> 2. EHO will notify the applicant if any EHD film exist. An appointment for review Will be cor&Irtnie <br /> approximately five businass days but no later than ten (90)days after receipt of application.; T w files <br /> will be held for a maximum of fiv4 business days for review. Appointments should be sche du <br /> l ad <br /> accordingly. <br /> s. A file that is actively being workod.on by EHD staff may not be immediately available for rolai i, A new <br /> appllCadon may be Submitted wh*n tho Site is available. <br /> 4, Any filo not returned In the setae Condition as releaasd will be r*organixod by EHD staff at the expense <br /> of the applicant. Future tllo reviews by tho same Applicant may require a$97.00 deposit prior 1 a ravigW. <br /> _ *TLKTA rNE appointment datso must be confirmed with EHD staff. <br /> • Applications rectiived after 3-.00 prn VIII be prose&St Cd the next business day. <br /> CONFIRMED APPOINTMENT DATI`, , TIME <br /> GATE Gt]h1FIRMI=Q PHONE FAX IMfCiAI� <br /> REVIEWED YES NO Rl1~ EW DATE <br /> I CI t QI A A? <br /> r <br />