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I� SAN OQUJN CDt]NTYPUBLIC HEALTH <br /> �1 1�� � ICES <br /> ENVIRONMENTAL 14EALTH DIVISION �5"1 " <br /> NOV 1 5 304 EAST WEBER AVENUE,THIRD FLOOR `/�.l/� <br /> 2000 STOCKTON CA 95202 l <br /> (209)4158.3420 ��/ y6 y a r 3$ <br /> ENVIRONN FNT HEALTH PUBLIC RECORDS RELEASE AP z Z ION <br /> PERM�PpSERNr a.0 <br /> BUSIN"SIAGENCY V _ <br /> ADDRESS � E IPA <br /> PHONE - 4 jFA/C510A E -3s_r7-( / �o,p p� <br /> TENTATiVE`APPOINTkENTDATE ../=1y 2�-MZ&g 2O 71ME Cl/O <br /> tv bu;lnsss days from Oaf apPNC <br /> t;oWUwi subrn".0 <br /> P CHECK BOX TO 6XPEOrrE REQug5T OF- - T�.00ESSED IN BUSINESS DAY5 <br /> SIGNATURE OF APPLICANT / DATE <br /> FILEADDRE55 THIS SIDE EHD STAFF USG;ONLY <br /> PXQORAM ELEMENTS SEARCH <br /> r n e 3saE d <br /> -7 <br /> _1 ' <br /> �/ ENVIRO MENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(USTI CLEANUP SITE(LOP) Q HOUSING ABATEMENT ❑ SOLD WASTE FACILITY <br /> arj OTHER CLEANUP SITE(NoN-Lop) ❑ FOOD rAC1UT7 ❑ SOLID WASTE VEHICLE <br /> O UNDERGROUND TANK(AtDNITORINWREMOVAL) O DOG KENNEL p pp <br /> 0" NA2ARDOUS WASTE GENERATOR 13 CHICKEN RANCH Cl OA: Y <br /> TRFRTLIEuTPLANT <br /> TIERED PERMITTED FACILITY 13 <br /> MOt9WMOTEL C7 PUMPER TRUCKMARMHEM TOa.ETS <br /> M TATTOOtBOOY PEIRCING ❑ Pd0IJSPA " " ❑ LAND USE APPLICATION SITES <br /> 4 MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> �. t.lst up to ten addresses In the space above_ Select tho.typels) of files from the list above by cheekinp <br /> the appropriate box(es). At least one file type MUST be se)ected. Fax to (209)4t14-0138 or mall to the <br /> addrQss indicated abavg <br /> 2. EHO 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 applicatian. The files <br /> Will be held for a maximum of five business days for feView. Appointments should be seboduled <br /> accordingly, <br /> 3. A file that is actively being worked on by EHD staff may not.ba immediately available for review. A new <br /> application may be submitted When the file is available. <br /> 4• Any file 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$87.00 deposit prior to review, <br /> S. 'TENTATIVE appointment dates must be confirmed with END staff. <br /> 6. - Applications received after 3:00 pm Will be pmcessed the next business day. <br /> i <br /> )2CINFIRMF-p APPOINTMENT DATE TIME <br /> k <br /> DATE CONFIRMED PHONE FAX INITIAL$ <br /> 7 <br /> kEVIEWEp YES No <br /> REVIEW DATE <br /> CN �1 ,• 0 app <br /> TOTRL P,01 <br />