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SM'jJWUIN COUNTYPUBLIC HEALTH IICES <br /> L'i- "ENVIRONMENTAL HEALTH DIVISIO <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> FEB 2 0 2001 STOCKTONCA95202 <br /> (209)458.3420 <br /> ENVIf?UVw,.Ekii HLALTH PUBLIC RECORDS RELEASE <br /> RELEASEAPPLICATION <br /> BUSINSSIAGENCY QQ1CeGh / &)" <br /> APPLICANT <br /> 5(ne i . <br /> ADDRrW <br /> ��ee -/D r•,...�.,.ItLa; 07 FE 0 2001_ <br /> PRONE '' <br /> V".T ''r TENTATIVE"AlOINTMEM DATE• L <br /> `"S� (Fiore give 7 to 10 bVfiina5B days <br /> from dam of appaptlon submittal) <br /> 77qq >' <br /> t[-v. CHECK BOX TO EJGPEDRE REQUEST.57V EE RE ST PROCESSED IN 8 BUSINESS PAYS <br /> � DATE DZ((5 �ot <br /> SIGNATURE OF APPLICANT <br /> FILE ADDRESS <br /> Z l2 u <br /> gsa7 »� I <br /> qr <br /> 3Saa �K <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(USTJ CLEANUP SITE(LOP) C3 HOUSING SOLID WASTE FACILITY HOUSING ABATEMENT ❑ SOLID WASTE VEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD KENNEL <br /> FACILITY ❑ DAIRY <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL <br /> ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ HAZARDOUS WASTE GENERATOR ❑ lIOTELIHOTEL ❑ PUMPER TAUCKIYARDICHEN TOILETS <br /> ❑ TIERED PERMITTED FACILITY ❑ POOVSPA E] LAND USE APPLICATION SITES <br /> ❑ TATTOO/BODY PEIRCING ❑ pUDLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> ❑ MEDICAL WASTE FACILITY ' <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 to l2p9t 464-0138 or mail to the <br /> address indicated above. <br /> 2, EHD will notify the applicant If any EIiA flies exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten (10) days after <br /> receipt <br /> thou dof plicasahe. The <br /> 11110s,will be held for a Maximum of five business days for review. App <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available Far review. new <br /> application may be submitted when the file is available. staff <br /> 4. Any file not returned in the same condition as released ill be reorganized <br /> a $78,00 E depot t prthe expense rev <br /> of the applicant. Future file reviews by the same app Yrequire <br /> w. <br /> S. "TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> LOATE <br /> FIRMED APPOINTMENT DATE TIME <br /> CONFIRMED <br /> PHONE FAX INITIALS <br /> EWED YES NO REVIEW DATE <br /> 14 4tN <br />