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Aug 25 06) 04: 1:i0p Nissa Mack 92Ft 4841942 p , 1 <br /> � � j�� EHD LOG NUMBER <br /> D <br /> LE SAM JOAQUIN COUNTY <br /> ENVITD1014MEN'1i'AL HEALTH DEPARTMENT <br /> MENT ,rf <br /> `� L006 304 ;1=.ast l& eber Avenue, 3r Floor, &CC7on, CA 95202 - 2'709 <br /> Werthonp� (209) 468-3420 )l+ ax: (.209) 464•-013$ Webs V�a�t�'. 5 ( DYr.�T G'Id <br /> LNViRONNILN'fT HEALTH <br /> PERM ' PUBLIC RECORDS PXLEASE APPLICATION _ <br /> RUSIWMWAGENC'Y: <br /> P140 ME (1 ): s ,� 1 � f ' f� !.. 1� - -_ _— PHONE (21: <br /> THE14YATWE1 ApPoimmEN7' flATI?: Time: <br /> tF lanse allow 10 husiness days from dafzs of application submittal • ' r'enfa6v,:only - must be ccomirmedj <br /> -a CHECK. V-GX TOEXPEDITR. REQUEST . "U(LFt=�r9 (CASH OR ECK ONLY) - REQIJImST 13ROCEySS45EfD IRS 3 P3UV ENESS DAY'S <br /> Sial,14TUR.E OFAIPPii_It:.l%R4T -,fes' - . ��- -- -- DATE <br /> i vNrr riiS u4my3u"r1Crd9 E:1 unkit 'STI Unit 2 ❑ Unit 3 0 Unit 4 C1 U.rnit 5 ❑ U0t a t7 Gthel (E:1< rtrozricAist::ln aps] �.� <br /> _- : .. , <br /> Yt.M6lifrfrrenlna.w�lrt[ fil.f�.ry: llL.RIw10Fa�lG��Y[���d/�) MCL <br /> �L�flli��� R� + �wrj6t'S <br /> _ <br /> FILE AID DRESS EHD WE ONLY <br /> Street all Street Eine;Lvf <br /> 3. ,;2 X5:3 _ � r�<�' ✓' -- — v1 <br /> h 100 , <br /> pcclfle Date !Za TgD Of lnfbr-irnaVmn RetrJested : FrOni <br /> ' i;li VORONMEWAL HEALTH DEPAWMENT FILES; <br /> - - <br /> �-.LNDrRGP.' t11) 5lkNi` (U5T) D"LF,AMUP STrE (Lf)P) 0 HousENG ABATEMENT SOL3a WASTz FACIL`.lYf JEMCLIr <br /> F Cq' l R CLLMFJl% :tiTE (t3oW .(Dfl) FOOD FACxm to WA!,14 T1RE <br /> 0. tFiYRERGIs3°JN(1 i'fiDLK (PflRNrTC F NG1riENiO'r AL) 0 DOG KENNEL C9 DAIRV <br /> F7AT�RUM1?Un MfFi:TTl= GMERATOR 'CMCKEN RANCH C7 Wf:TERATER TKEAT"5 T PLA 47 <br /> ;1!T%TIWED PEJIldI'rl'' '11 FA(:1LITY - D MOTELIHOTEL [� Pu11FERTRu1cKr*,FDfrvM iA Tougrs <br /> El TAT''oafBtmY PiE:Rcom 1:i1,PO0USPA LAmo USE AF'PLY•:jrmoN Sr Es <br /> 1:1 VEDIC,FAXTAST1: RWILrrY E:1 bTHER (PLEAa"ESPECIF`.')_ <br /> IEN£LLMM SEPTIC- PeRfAr% RrCDRt)3 ARE AYAELAeLer-ort R_+AEw - MONnAYPFRIDAY $:4017 :4Mw6 :(Nk m - EXcujiji @-a lvlo IoAm <br /> 1 . List IAP to tem addresses iia the space above!, Select the type(s) offiks froth $Illi list above bryt teckinccj thev�� <br /> appTopriate bwx(es). At letast om file type MUST be selected. Fax to (209) 461_U138 or mail to the addrerss <br /> indivatrW ckove . Addrewi ranges will not tie accepted - for additional assistance with Me slddresr�ea, ift.oR a at <br /> tfie f: Hla. ,pplicaatiotis rixe%ivei after 3 : 010 p!m will be processed Mie next business day. <br /> The EHD will notify [:he cp pficarit if any EHD files eidst. An appointment for ireview wrill iyt conffinned <br /> apprwckna (:ely tell (1 0) dais aftw receipt of application. The files will be held for a maximum of five bNJS )nal„t <br /> days ftr review. Appoirtfinents c0wulid be scheduied accordingly. <br /> :>. A file that i3 actively b einS3; worked on by EHD staff may not be immediately aaysiilaWe for revlem A new <br /> applicsticlri mw iryr Gee iubmMe d ldrben the file is availaisle, <br /> 4m Any fila nor' rilturned in the same condition as released vd1l be reorganized by FHD staff at the experlss of th+1 <br /> applicant. R1111re file: r1e'viPWs by the same :tppiicant may require a $95.00 depulsit prior to mview, <br /> acre ya.ne -------- — - - -•---- -_ —_� __.-- <br /> fiH /a"r3 - ' <br />