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.. a <br /> 04/10/03 THU 13:02 FAX 925 253 4985 - TREADWELL & ROLLO lid 001� <br /> 1}/]( �,ea�oc�ur.nea <br /> r 71 tI 1 LTJ SAN O QUIN COUNTYPU»[.IC HEALTH S <br /> ER <br /> ENVIRONMENTAL,HEALTH.DIVIS10N I <br /> APR 1 0 2003 ~ 304 FAST WEBER AVENUE,THIRD FLOOR 1 <br /> STOCKTON CA 95202 (eo <br /> ENVIRONMENT HEALTH (209)463-342022- <br /> PF.RMIT/SERVICES PUBLIC RECORDS RELEAS8 APPLICATION <br /> APPLICANT �6� HUSENESS�I,I:NGY r-u�ils, ----- <br /> ADDRESS I (^�'�'"—� —. ' /d J <br /> PNON£• Z _z - x F C;SIM) <br /> pLIt.1s �- drr ZZ- <br /> TEI+l7A"[LVE`APPOTNYME.NT DATE O 3 TIME O'b <br /> (Please give T to 10 bustnoss dal frarn dais of apptication SubrnlUal) <br /> CHkCK 130X TO rXPEDITE RE4UES 9.40 FEE UFtiS7 PRO 5ED=BUS �GYS <br /> k1l <br /> s <br /> SIGNATURE OF APPLICANT / X -pgZ t` -- -=�-- <br /> FILL AODFtFSs THIS SI[aE ENO 5'>,qf F USE ONLY <br /> PROGRAM EIxv-ME i $1rWiGH <br /> W�5� <br /> '-10b Tcr�c � •� <br /> �y W <br /> y'1 w�s� • Q • <br /> 2- T vaf rd <br /> ler, ZIA.Graoft <br /> ENV)RQNMENTAL HEALTH DIVISION FILeii <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUVNG ABATEMENT D SniJI3 WASME sFACILfff <br /> OTHF-R CL£fWUP SFTE(NON-LOP) O FOOD FAGLRY O'SOLID WASX9 VEHICLE <br /> �f UNbERGROUND TAXK(maNffORING1REMOVAL). ❑ DOG KENNM D DAIRY <br /> HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH D P11:G TREA-g4ENT PLANT <br /> TIERED PERMYTEO FACILM 0 MOTEUHOTEL O Pi) MPFR TIttJC:KNARD(I�HEM Tf)l_E'f5 <br /> D TArraoisonY PEtRCWG 0 POOLISPA ❑ LOND USE 4PI'UCATI6i%1 SITES <br /> O MEDICAL WASTE FACILITY D PUBLIC wAireFt SYSYiem Q O•rNFR IPLeAwE SPECIFY ABOVE) <br /> 1. List up to ton addresses in the space above. Select the type(s) of Tih;.5 from the•list above by clieching <br /> the appropriate box(es). At least one file type MUST bo selected. FaX ID 209 464-0138 or mail to tt!e <br /> address indicated above. <br /> 2. END will notify the applicant if any EHD tiles exist. An appointment for review Will be confirmed <br /> approximately five business days but nv later than tett(10)days after receipt of applicdtiori. Tile f iles <br /> will be held for a maximunn of five business¢Sys for review. Appointments should be scliadulad <br /> accordingly. 1 <br /> 3. A file that Js actively blaIng worked on by END staff May not he immediately av+iAilable for review. Anew <br /> application may be submitted when'tho file is available. <br /> 4, Any file not rettirncd in the same conditions as ruleaxpd will hq reorganked by EHD stair at the expense <br /> of the applicant. Future file reviews by the same applicant may require a $89.00 deposit'prior to rovicw. <br /> 5. *TENTATIVE appointment diates must be confirmed with END staff. <br /> .6. Applications received after 3:04 pm will be processed the next busines�i day. <br /> CONFIRMED APPOINTMENT DATE. TIME <br /> DATE CONFIRMED PHONE FAX. lNiTIALS <br /> REVIEWED YES NO REVIEW DATE <br /> •tl w,Ike • <br /> T :OT 7GIG47J;'TJTT <br />