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Y <br /> 09/11/2002 16:07 20� 79-2225 MODESTO ATC PAGE 01 _ <br /> .N.... •... t ._ <br /> -3-�� 4u.� iu�u�.tJ. <br /> n2�(c•►►�� �� [�} S IN COUNTYPUBLIC HEALTH SERVICES ()�L�C�l.I V L�LV/ <br /> U1]�C L��LL - ENVIRONMENTAL HEALTH DIVISION l L Lel. �'/ L 0, <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> SEP 1 2 2002 STOCKTON CA 95202 SEP 1 2 2002 <br /> (209)468-3420 <br /> ENT HEALTH PUBLIC RECORDSRELEASE APPLICATION ENVIRONMENT HEALTH <br /> FERM _ <br /> APPLICANTI BUSINESS/AGENCY LCO 140 <br /> ADDRESS t� <br /> PHONE <br /> FACSIMILE <br /> TENTATIVE'APPOINTMENT DATE__ 1 h-d/QZ _ TIME 1(l <br /> (PIC240 Vivo 7 to 10 busines's da —Irol a of op <br /> E <br /> (Cation:ubmlttal) <br /> a ' ' - <br /> CHOCK BQX TQ, CPkDITE REQUEST- 7.0 QUI:S PROC 5 D( 3 <br /> BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 9 h <br /> FILL;ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> l- PROGRAM ELEMCNTS SEARCH <br /> }. <br /> i S t <br /> hbkk, n <br /> CPO4 <br /> w <br /> 0 GIS U <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON•LOP) . O FOOD FACILITY O SOLID WASTE VEHICLE, <br /> ❑ UNDERGROUND TANK(MONITORING/REMOVAL) O DOG KENNEL O DAIRY <br /> ❑ HAZARDOUS WASTE GENERATOR O CHICKEN RANCH O PKG TREATMENT PLANT <br /> ❑ TICREO PERMiTTD•FACILITY 13MOTEIJHOT9L ❑ PUMPER TRUCKIYARDICHEM 701LETS <br /> O TATTOOIBODY PJJACING ❑ POOL►SPA O LAND USE APPLICATION SITES <br /> ❑ MEDICAL WAS'rg FACILITY O PUOLIC WATER SYSTEM O OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ton 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 r <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 sch•cduled <br /> accordingly, <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A now <br /> application may be submittecl when the file is available. <br /> 4. Any file not returned in the same condition 25 releazod will be reorganizod by EHO staff at the expense <br /> Of the applicant. Future file reviews by the same applicant may require a$87.00 deposit prior to review. <br /> 5. *TENTATIVE appointment dat¢s must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DA <br /> TIM <br /> DATE CONFIRMED , <br /> PHONE F INITIALS <br /> REVIEWED • YES <br /> w oo o M-9 <br />