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PROM NOA Environmental PHONE NO. : 209 369 4228 Dec. 23 2002 12:25PM P4 <br /> �4u;auNakR <br /> i;5) N.J10, 1. COUNTYPUB C HEALTH'SERVICES <br /> RONMENTAL HEALTH DIVISION I <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> EC 2 2002 ST (209) <br /> C�95202 <br /> (209)X408-420 <br /> 6A° ,'�RnrupUBLIQ_RECORDS REL�AS E'APPLI CATION <br /> APPLICANT �+',,�ff _ EUSiNMIAGENCY <br /> AbORE,SS Z elf_ .gm,5A+1_Ls '.,,—A-.1 T et L`r..`.,., <br /> Puor4c 62oci 30-770 r _ 1 AC51M11� 4 <br /> TENTATIVE'APPOINTMENT DAE hZo3 TIME b3 <br /> � A <br /> (Please give 7 to 10 busineat dayia frasi date of application SubmHtaq <br /> CHECK 80X TO EXPEOXTE REQUEST-$89.00 FEE Rl"c t:$ PROCESSED IN 3 BUSINESS DAYS U 0 <br /> SIGNATURE OF APPLICANT DATE 3 <br /> k e• . <br /> FILE ADDRESS THIS SIDE Irmo STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> 'S $. &4ruket Ln. ed; ,�. <br /> 3 S. v6p- c I <br /> 3 A00 ; fir <br /> 5 r. Lo �,. <br /> f.� <br /> We f 6T <br /> ENVIRONMENTAL,HIAt.TH DIVISION FILES r <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) O HOUSING ABATEIA"r O SOLID WASTE FACILITY <br /> Sr OTHER CLEANUP SITE(NON-LOP) C) FOOD FACQ SOLID WASTE VEHICLIt <br /> CC UNDERGROUND TANK(LooNITORINGIREMOVAL) 0 DOG KENN1=L D DAIRY <br /> e HAZARDOUS WASTE GENT=BATOR O CHICKEN RANCH O PKG TREATMENr.PLANT <br /> Cl 'nERED PERurrrED FACIVw C3 MOTELMOTEL 0 PUMPER TRUCKIYARDICHEM TOLL. <br /> 13 TATTOO BODY PEIRCtNG 13 POOLISPA q LAND USE APPLICATION SRE <br /> 0 MEDICAL WASTE FACILITY O PUBLIC WATER SYSTEM W O'1T14CA(PLVASt SPEOWY AWYM <br /> 1. List up-to ten addresses in the space above. Selectk 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)4G1-01-38 or_mail to the <br /> address Indicated above. <br /> 2, EHD will notify the applicant If any IEHD fetes exist. An appointment for review will be c6nflrmed <br /> approximately five business days but no later than Oen(10)days after receipt of application. The files <br /> will be held for a maximum of five business days fo`rreview_ Appointments should be scheduled <br /> accordingly. <br /> 3. A file that Is actively being worked on by EHD staff may not be Immediately available for review. A new. <br /> application may be submitted when the file is aValft ble. <br /> 4. Any file not returned in the same condition as released will be reorganized by P-140 staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a$89.00 deposit prior to review, <br /> 5. *TENTATIVE appointment dates must be confirmed with END 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 /> E <br />