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Jun 03 02 09 : 33a , <br /> W 06/03/2002 D9: 2U -�5a U136 — P • 1 <br /> rxc rvr EM/[RO i+ E YTPL HEALTH 011 <br /> SAN JOAQUIN COUNTYPUBLIC IN !, kLTH SERVICE%a . I <br /> li ENVIRONMENTAL HEALTH150 FLOOit <br /> 904 FAST WEBERAVENUE, THIFD FLOOR <br /> STOOKTON OA 9510 <br /> (209) 488.7420 T69 <br /> t1133LL'IC RECORDS RELEAS ci , 1PPLICATION <br /> APPLICANT L /�/f BUSIHE$SIgGENCV - <br /> ADDaESB .s , E WED <br /> PHONE <br /> PACaIMILEy-_��iac l�c�IIi�^ <br /> )! ? TENTATIE/90RITMNATE am- m TIME <br /> �s <br /> JUN 0 4 2002 <br /> [ Y `/0IPleaselrs71010bus <br /> C— <br /> CHECK SOX TO EXPEDITE EST - les, FEE - CIS , SI i ENVIRONMENT HEALTH <br /> SIGNATURE 01 APPLICANT G �� DATE �v G P� ERMIT/SERVICES <br /> FILE ADDRESS TRLS SIDE EHO STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> .�i" ENVIRONMENTAL HEALTH DIIIS :ON FILES <br /> OA�UNOERGROUND TANK (UST) CLEANUP SHE (LOP) 0 HOUSINGADATENEN'I' 0 SOLID WASTE FACILITY <br /> BOTHER CLEANUP SIM414ON-LOP) 0 FOOD FACILITY 0 SOLDWASTEVEHICLE <br /> J;WUNDERGROUNO TANK (NONrrDRINCREMDVAL) 0 DOG KENNEL 0 DAIRY <br /> O """"US WASTE GENERATOR ❑ CHICKEN RANCH - 0 PKG TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILHY ❑ MOTHUHOTEL 0 PUMPER TRUCKP/Ag01CHEM TOILETS <br /> O MEDICAL WASTE FACIHLITY <br /> 0 TATTOODOOYPEIRCI . 0 POODSPA - 0 LAND USE APPLICATION SITES <br /> ❑ PUftuCWATERSYS'R: V 0 OTHER (PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses In the space above. Select the 1j ; e(s) of files tram the list above by checking <br /> the appropriate box(es). At least one file type MUST be sHl toted. Fax to (209) 464-0136 or mal to the <br /> address Indicated above <br /> 2. END will notify the applicant H any EHO files exist An : p) Nnlment for review Will be confirmed <br /> approximately five business days but no later than tan 11111 days after receipt of.application. The files <br /> will be held for a maximum Of five business days for rot'lee 1. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by END staff may n o : be immediately available for review, A new <br /> application may be submitted when the Ne Is available. <br /> 41 Any file not returned in the same Condition as released W 1 be reorganized by END staff at the expense <br /> of the applicant. Future file reviews by the same applic ) I t may require a 699.00 deposit prior to review. <br /> S. TENTATIVE appointment dates must be confirmed wiul I91D staff. <br /> 6. Applications received atter 3:D0 pm will be processed 9841 I next business day. <br /> CONFIRMEDAPPOINTMENT DATE. _ "IME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED__ YES _ NO RE% 11.1 / DATE __ <br />