Laserfiche WebLink
Ji.f i;l+iCfilVkD <br /> 467111L P.fal <br /> SAN A*L'N CQUNTYPUBLIC HF- 4L.TH SERVICES <br /> '04VIRONiUIEWAL HIA4TH DIVISION <br /> 904 EASTPEB ER AVENUE,THIRD PLDOR <br /> 3TOCKTON CA 96202 <br /> RE' <br /> (209)488-42.0 <br /> MAS>_:16 RECOROS RELEASE APPLJCATION <br /> t <br /> APPUCANT <br />' BUSINE3.SlAL3ENCY <br /> a. r1Rt S9 a' .S <br /> ONONE ZO ` <br /> TNE.6 <br /> FACS[1dlI z 7 I <br /> TENTA - <br /> Af'POIP['f7dE++Tt SATE ��! 71h1E <br /> (Please give 7 io to bu&iMOSS days Im, dateAappUc�li t aulrrnittal} <br /> CHECK DOX TO EXPEQiTE RERLFES'r-1S8'T_DQ FEE='REQUEST PR(?CESGEO W @{{$1NE$3 DAYS <br /> 9NATURE OF APPUCANT 1 :i <br /> DATE 4 40 <br /> FILE ADz7R7-$3 THIS SLOE ErD RTAFF USEOZyLY <br /> E! <br /> pFI;CGRAlli EIL3EAfF3 <br /> t`4 SF?1tR014 <br /> I oz �T.{r R a k-r 3S <br /> 4NVtRbNM1=NTAL HEALTH Di SI'ON FILES <br /> "OKUNDERGROUND TANK(us'r)Ci-EANup qg-E(LQp) ❑'.KOu4IHG At3ATEMF.NiT 0 SOLIo WASTE FACiLrrY <br /> E3 C rNSA MEANUP STYE(NON-coq) ' ` l d V OD FA 0TY G uouij WASTE VEHIGM <br /> UM)F!FkQR0UK0 TANK{l1tt7NCrbf;3Nbl OVAL) R'j,DOG KENNEL C3 DAIRY <br /> L2 hAZAFk00U5 WASTE G(EMN0 7q1� 13"CHICKEN PANiC�r TOILETS <br /> L7 TIQ PHO TRL�ATIItI�IfI PLANY <br /> 77ERED PLI7,�yI1T"rlE 4 FACILITY C3�tk3QTE11NATF1 0 PUMP ATRUCKIYARVICHEiN <br /> E] TAT1'CW9t3[7Y FELRCtNG C] PDOLJSPA i3 [.AMD USE APPLICATTtlI+t Srrn <br /> MEDICAL WASTF-FAGlLr" 13'PUBL;C yVATER SY$TE[If Ck fl7HRR(PLEASE SPECIFY ABOg1M <br /> l• Llst up to ten'addresses-i�the space„above. Select the type(s)of#iics from the list above by checking <br /> the appropriate boxes)-'At laastjone file typo MUST he selected. F 209 -0t� mall td <br /> address I&JwAtad also <br /> :. <br /> 2. EHD will notify the applicant If any EHD files exist; An appo[ntment for rilview will bi confirtned <br /> approximately five buriI ells dsys but Ino later than ten(10) gaYS after receipt Of application. The files <br /> will behold for d ritASCimurr3 of five bustness daze for review. Appointments sh <br /> aaWd bo scheduled <br /> �aQrdingly. <br /> 3. a,#i!e that is»ctiYely beirtgjworlted 4n by Erie stgtf may not be Immediately i?mmllable for review. Anew . <br /> application may be submitted when th4 file is ava[table. <br /> 4, Any file not returned in th4 92MO 6anci-tion as releanW Will Ire reorganizecl <br /> of this atpplica,nt. Future file reviews ka ;the same Y $ by EHDstaff at the expense <br /> Y applicant tris re utrs a 87.00 deposit prior to rev-OW <br /> r'TE#VTATtVE appointment dates must-be canti mud w[th I;Ho stuff. <br /> 8. Applications recalved after 3:00 Pm Will bQ proc'essed the next bustneza day, E <br /> CONFIRMED APPaltirmztjT a�XF <br /> TIME <br /> DATE CONFIRMEv <br /> PHONE FAX INMALS <br /> l±;E1/!l+`V!!Ed .YES .1 No °a; <br /> eH. oavoREVIEW DATE ' <br /> TOTAL F1.01 <br /> t <br />