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03 26PN $%wol <br /> 0 A"r e S 4. L* SAN JOAQUIN COUNTYFIBLIC HEALTH SRV I C E S <br /> ENVIRONMENTAL. HEALTH DIVISION <br /> FEB 2 6 2001 304 EAST WEBER AVENUE,TWIRL}FLOOR <br /> STOCKTON CA 95202 <br /> (209)469-3420 <br /> "T"SE-RViCES EASE APPUCAMN <br /> P'llivil 1, PU13LIC RECORDS RF-L <br /> V4BUSINE551AGeNCY <br /> APPLICANT <br /> v <br /> PHONE <br /> FACSIMILE <br /> z 00 4M <br /> Time <br /> TP <br /> TENTATIVE*APP DA" <br /> (flease give?to 10 bust" fr <br /> 33 days o;"date of ppac*tion's Wall) <br /> CHECK BOX TQ EXPRDITE rf(juEST-Sal,.aa FEE-REQUEST PROCESS ED IN 3 allSINESS DAYSDATE <br /> SIGNATURE-OF APPLICANT <br /> TFti3 SIDE E:titi STAFF SE ONLY <br /> pROGRAM ELEMV;t S SEMCH <br /> '3 <br /> -7 rA <br /> 4-W <br /> CL" ............... <br /> ENWRONM"TALELTH DIVISION FILE <br /> a SOLID WASTE FACILITY <br /> SI)CLgANUp SITE(LOP) 0 HOUSING ABATEM"T M 50LID WASTE VEHICLE <br /> )1CIJI4P5iRGROuXD TANK(U C FOOD FACILITY . 0 FAIRY <br /> 0 OTHER CLEANUP SITE 0143N-Lop) 0 DOG KENNEL ' PLANT <br /> aRINGfRFM [3 OVAQ 0 PKG TRF-ATMF-NT <br /> [3 UNDERGROi�NDTANK(MONIT K . 0 M(yTF.Ljj40TP.L <br /> 0"iGKEH RAMON 13 ?1 jMpgft TrtUCKryAgOICH 0A TOILETS <br /> AZARogus vVASTE GIENERATOP <br /> -Y . in IANC}U.$f.APpLicAmoN SITES <br /> R.ED peRWTTF-D FAQUT M pOOUSPA <br /> ❑ 0 OTHER(PLEA!W SPECIFY ABOVE) <br /> 0 TATTOIC0013Y PPIRCING 0 pUl3uC WATER SYSTFU <br /> 0 MF-010AL WASTE FAWI-11-y checking <br /> type(S)of files from the list above by <br /> ISS06 in the SpaceabOV4. Select the LLO-ft <br /> 1. List up to ten addresses e MUST be selected., <br /> " ---- <br /> tappropriate bo:(-0 S). A%least one file tYP <br /> jconfirMed, <br /> 249ti S z�%n . if any E140 NOS eXist. An 2ppointmont for review Will 130 <br /> 2. F,14D will natify the applicant later then ten(101 days after receipt Of application. The files <br /> approximately five�Usjnqss days but no a scheduled <br /> will be held for a m,"ximurn of five business days for review. ApPOkntments should b <br /> 3. <br /> accordingly.Afire that is actively beiAS1 warked on by EHD staff may not be immediately available for review. A now <br /> application may be'subi-nitted whom file IS available. <br /> the od will be raorganized by EHD Staff at the expense <br /> condition a3 relear re a$97.00 deposit Prior to review- <br /> 4- Any file not re%urnoti In the SaMQ . <br /> 01 the applicant. Future rile r"jawa by ttila Sam*applicant May r"equi <br /> 5. 'TENTATIVE apPOliltment dates Must bt canfirmad with the EHD <br /> business dAY- <br /> st*M- <br /> 6. Applications received after 3-00 Pm will be Processed next <br /> CONFIRMED APPOINTMENT DATE <br /> TIME <br /> I D-ATF,coNr-iRmED pi-IONE FAX INITIALSYES NO -- <br /> REVIEW DATE <br /> REVIEWED <br /> TOTAL P-0? <br />