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„ <br /> i'0'39Ud 1U101 ** <br /> ., w..�� �,..�/►+ c�tiv ttcuiwiUv i r�L �.+iL i n r'Hl7t !)1 <br /> rn .n:�C.rGV <br /> COUNTYPUBLIC HEALT 81 <br /> LVIN <br /> RONMENTAL HEALTH DTVI <br /> Q4 EAST � 8V <br /> 20 <br /> OT WEBER AVENUE,THIRD FLOOR <br /> SEP 1 2 L STOCKTON CA 95202 SEP 1 2 <br /> (209)468-3420 <br /> 10OCORDS RELEASE AP <br /> APPLICANT SFE �R IrQYl I _9USINESS/AGENCY_ �S� PERMIT/SERVICES <br /> ADDRESS O 2Tj&twQ44(A-1 �, , S e Ogg 14 — <br /> PHONE S10 -y3y` 9400 r FACSIMILE 610 <br /> TENTATIVE'APPOINTMENT DATE / P- TIME /6 16y <br /> (Pleas*give 7�o si�ttoa <br /> om a of Y19CU2SI <br /> lion submittal) <br /> CHECK aOX TO EXPEDITE RE ST.;89.0 F RQQSt�1NESS DAYS <br /> 'SIGNATURE OF APPLICANT DATE <br /> FILE ADDRESS THFt SIDE EMD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> h Iv A hi✓ L21 ck <br /> S• <br /> W. C <br /> JO LO <br /> (a G <br /> Ci4i Air. <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) O HOUSING ABATEMENT tO SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY O SOLID WASTE VEHICLE <br /> Q UNDERGROUND TANK(MON ITORINGIREM OVAL) ❑ DOG KENNEL C DAIRY <br /> Q HA2JIRDOU5 WASTE GENERATOR d CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> C3TIERED PERMITTED FACILITY 0 MOTEL/HOTEL ' n PUMPER TRUCKIYARD/CHEFiI TOILETS <br /> CI TATTOOMODY PEIRCING O POOL/SPA 0 LAND USE APPLICATION SITES <br /> M MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to 209 464-0138 or mail to the <br /> address indicated above. <br /> 2. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than 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 scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by END staff may not be immediately available for review. A new , <br /> application may be submitted when the file Is available. <br /> 4. Any lila 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 applicant may require a$99,00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be Confirmed with EMD staff. <br /> 6. Applications received after 3:00 pm 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 /> -+ _ FO/Eo'd 82:T0b9b60ET 01 dd 9E:TT E00Z 11 d3S <br />