Laserfiche WebLink
MAR-16-2007 09:01 CANDOR EARTH TECH 209 532 0773 P.01i01 <br /> 0AIN JV^%ZULI\ %,,%,r"I A A <br /> EXV-Mo NMENTAL HEALTH DFPARTMNT <br /> l00( . 304 B Weber Ave 3`d Floor Stockton, CA 95205 <br /> WAR 09)468-3420 Fax: (209)464-0138 Web: www.co-san joaquin•ca uslehd <br /> ? Z,3 <br /> ENVIRONMEW i EN TH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICA'T'ION <br /> r)rh'�rE.tz� ones <br /> APPLICANT. t BUSINESg/p,GFNCY: <br /> ADDRESS; . ��� � '�N � <br /> PHONE: • - v ` d 6 ( FACSIMILE: �D q. 3 a 6 3 <br /> TENTATIVE'APPOINTMENT DATE: <br /> (please allow 10 business days from date of application aubmittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$93-00 FE —REQUE37 PROCESSED IN 3 BUSINESS DAYS <br /> PATE <br /> SIGNATURE OF APPLICANT <br /> Department Use Only <br /> UNIT <br /> FILE ADDRESS <br /> 1.-.V , Unit 1 <br /> p � a <br /> 2. Sint (1 <br /> X17 a s, . -, [3 Unit 2 V� <br /> - <br /> q <br /> S C A►zT R • a Unit 3 <br /> 6, sVeet L Unit 4 <br /> 7_ street <br /> 17' G <br /> e• Unit 5 <br /> 9_ sweet 19 <br /> I, CRY <br /> ,a. saner � 3 <br /> ENVIRONMENTAL,HEALTH DEPARTMI`NT FILES <br /> QSOLA)WASTE FACE <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) �HFOOOUDDIFAABATEMENT ENp,( SOJJD WASTE VEHICLE <br /> OTHER CLEANUP SITE(NON-LOF) DOG KENNEL 13 DAIRY <br /> ❑ <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) QCH 13ElPKG TREATMENT PLANT <br /> '(HA7RD <br /> AOUS WASTE GENERATOR CHICKEN E3 MOTEUN RANCH <br /> PUMPER TRUCK/YARDICHFM TOILETS <br /> C1 TIERED PERMITTED FACILITY Ll pOOLISPA O LAND USE APPLICATION SITES <br /> ❑ TATTOO/DOPY PIERCING ❑ OTHER(PLEASE SPECIFY) <br /> W MEDICAL WASTE FACILITY <br /> 1, List up to ten addresses in the space above. Select the types)of files from the list above by Checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to 209 4"A138 or mail to the <br /> address indicated above, confirmed <br /> 2, END will notify the applicant if any EHD files exist. An appointment <br /> ppoin s after receipt et f all becat on The files <br /> approximately five business days but no later than ten(10) y P pp <br /> will be held for a maximum of five buriness days for review. Appointments should be scheduled <br /> accordingly. worked on by EHD staff may not be immediately available for review, A new <br /> 3. A file that is actively being <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 applicant. Future file reviews by the Same <br /> must be confirmed with EHD sicant May taff. <br /> require a$93.00 deposit prior to review. <br /> 5, 'TENTATIVE appointment <br /> 6. Applications received after 3:00 pm will be processed the next business day, <br /> CONFIRMED APPOINTMI=NT DATE TIME <br /> DATE CONFIRMED <br /> pHON5 pAx INITIALS` <br /> REVIEWED YES NO REVIEW DATE <br /> END 44-01-00 <br /> TOTAL P.01 <br />