Laserfiche WebLink
Sep 09 02 01 : 57p Caltrans 2099487782 p. 1 <br /> 09/89/2082 :26 46401 ENVIRONdENTAL FlEAL'� PAGE 01 <br /> SANN16AQUIN COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL <br /> HEALTH DIVISION <br /> 304 EAST WEISER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> a (209)468.3420 2FAJbUC RECORDS RELEASE APPLICATION <br /> APPLICANTat.a. t iso1.�h3on BU31NE113mc uCY_C AIkn% 01 TYa Y <br /> ,ADDRESS 197 6 E C.hoa-+cr W S �Is,' Ch. ���„ <br /> PHONE (ZQq)4q 12 FACSIMILE QZM)�I�S�77SZ Cf� H�•�(1U2 <br /> TENTATIVE'APPOINTMENT DATES 9*Z3 'Z00?— TIME 1400 EfNT HEALTH <br /> (Please sive 7 to 10 �, <br /> PERMIT/SERVICES <br /> CHECK BOX TO EXPEDITE REQUEST- ES AYS <br /> SIGNATURE OF APPLIC DATE f I Zeo - <br /> FILE ADDRESS THIS SIDE EHb STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> piAGt S I•Iw Al Stftk' &-x . <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) O 1K)MWG AaAT'EMENT O SOLO WASTE FACAM <br /> 0 OTHER CLEANUP SITE PION-LOP) O FOOD FACILITY 13 SOLID WASTE VEHICLE <br /> XAMMMMOUND TANK(MOWTORMIGIREMOVAL) O DOG KENNEL 17 DAIRY <br /> O HAZARDOUS WASTE GENERATOR b CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> O TIRED PERMITTED FACILITY O MOTELMOTEL O PUMPER TRUCKIYARINCHEM TO*ATS <br /> O TATTOO18ODY PEIRCING 13 POOL13PA O LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY CI PUBLIC WATER SYSTEM O OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above. Select the type(:)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(2091404-0 138 or mall to t e <br /> address indicated above. <br /> 2. EHP will notify the applicant N any EHD files exisL An appointment for review will be confirmed <br /> approximately five business days but no later then ten(10)days after receipt of application. The files <br /> will be held for a maximum of five business days for review. Appointments should.be•scheduied <br /> accordingly., <br /> 3. A file that is actively being worked an by EHD staff may not be immediately available for review. A new <br /> application may be submitted when the file Is available. <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expense <br /> of the appiicanL Future file reviews by the same apppcant may require a$59.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pIn will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> r <br /> r <br />