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V I��VI LSU SAS J E, UIN COUNTYPUBLIC HEALTH SE <br /> 1V1 O M NTAL HEALTH D VISION"w"cEs <br /> JUL 0 3 2000 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> ENVIRONMENT HEALTH (209)468-3420 <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICA ON <br /> APPLICANT � —�— <br /> »uslx�IEssrAo>�xcY d- n <br /> ADDRESS <br /> n 15PRONE l � � 1 —FACSIMILE <br /> TENTATIVE`APPOINTMENT DATE TIME <br /> [please;I ya 7 to 10 dusinecs days from date of application Submittal} <br /> CHECK BOX TO EXPC;)ITE REQUEST-$78 00 FEE–REQUEST PROCESSED 114 3 BUSINESS DAYS <br /> lGNATURE OF APPLICANT DATE : r <br /> FILE Ab5RL5S THIS SIDE END STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> 5ZG <br /> o S W Gh4rtelr Lo a tkran L C� ffl,i G lnt.o N ST. cLctan S5tZzo ZuP �r W a 3-S (_W Gkar W W 3of to , lAtnit. od i 3L 4AzG 3 2 <br /> aD � r Cwtti 5 TY�T <br /> 01- <br /> ENVIRONMENTAL HEA 7tH DIVISION FILES <br /> ❑ HOUSING ASATEMI=KT 0 SOLID WASTE FACILITY <br /> ,0 OTHER CLEANUP <br /> TANK{UST}CLEANUP SITE(LOP) Q FOOL)FACILITY 0 SOLID WASTE VEHICLE <br /> O OTHER trLEgNUP 517E[NON-IOP) VA <br /> O UNDERG120UN0 TANK jMONiTORINGrf2EMOYAf,} 0 DOG KENNEL 0 DAIRY13 CHICKEN RANCH ❑ PKO TREATMENT PLANT <br /> (2 HAZARDOUS YVA.51E GENERATOR fl MOTI=LIHQTEL E3 PUMPEK-tKUCKIYARDlGHEM TOILETS <br /> ❑ TIERED PEMCITED FACILITY C3 PoOi1SPA L] LAND USE APPLICATION SITES <br /> ❑ TATTO01800y PEIRCING O OTHER PLEASE SPECIFYABOVE) <br /> ❑ MEDIGA1-YYA�`TE FACILITY O PUBLIC WATER SY'S'[EI+S f <br /> t, List up to ten addresses in the space above. Select the typc(s) of files from the list abode by cheating <br /> the appropriate box(es)- At least one fila type MUST be selected. Fax to {209 464-013 or mail to the <br /> ad!areSS indicated a_t?oye. <br /> 2_ EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately five appiness days but no later than ten(10)days after receipt of application. The files <br /> will be field for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be Irnmediately avallable for review. A new <br /> alpplication may be submitted when the file is available. <br /> 4_ Any file not r4tUrried in tate same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant_ Future file reviews by the same applicant may require a$78.00 deposit prior to revleW. <br /> 5. `TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3.00 pm will be,processed the noXt business day. . <br /> CONFIRMED APPOINTMENT DATE <br /> TIME <br /> INITIALS <br /> FATE CONFFIRMED PHONE FAX <br /> �EVIEWED YES Wa REVIEW DATE <br /> TOTAL P.D1 <br />