Laserfiche WebLink
89-t9--2o00 16 2iki FROM <br /> 8a�- MINIM Lx94Ati IiUM1iBER <br /> ' o I� JOAW COUNTYPUBLIC HEALTH SERVQS <br /> ENVIRONMENTAL HEALTH DIVISION <br /> I 304 EAST WEBER AVENUE,THIRD FLOOR <br /> t: Z C U U 1 STOCKTON CA 953 32 <br /> (209)488-34.24i <br /> _a;_ �i 'USLOC RECORDS RELEASE APPLICATION � <br /> APPLICANTMik,e Frere BU81NE8sIAGEttcy Henshaw Associates, Inc. <br /> EaoREss [1}1$75 Dublin /Bvd, Suite A-200, Dublin, CA 94568 f7j <br /> �NaNe <br /> j Tl�htT <br /> VE*APPOINTMENT DATE j/4 I ;:7WE : ,"p o .0401 re <br /> l 4 ;.tPl9rasp ptale T to 10 basin®aa days Tram elate '>'f apRl'cativn a++bmittatl ZUU� <br /> CHECK BOX TO EXPEDITE REOUFST•$87.00 Fel° 7ESTPR lt5S81►IN S BUSINESS RAYS <br /> r <br /> SIGNATURE OF APPLtCAHT/ -.�,,I `� — - -- DATE �3 <br /> I <br /> Fu.E AapRE$$ THC!SIDt:t:HD STAFF Lh4E ONL <br /> I Q=-- <br /> PROGRAM E49MENT9 OEARCH <br /> 1 <br /> NFF ` 5 <br /> 17 rin <br /> I <br /> i <br /> ENVIRONMENTAL HEALTH DIASIOH FILES FED 28 2n01 <br /> UNPERGROUND TANK(UST)CLEANUP SITE(LOP) O HOUSING ABATI:MEI IT M $OLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON4.OPi = FOOD FACILITY d 80610 WASTE YEHICLE <br /> U1400RGROUND TANK(MONITORINCIIRIMOVAL) In DOU KENNEL 0 DAIRY <br /> HAZARDOUS WASTE OENIERATOR 137 CHICKEN RANCH 13 PKQ TREATMENT PLANT, <br /> ❑ TIERSD PfRMITTEA FACILITY 0 MOTELIHOTEL o PUMPER TRUCKIYARDICHEM TOILETS <br /> C TATTO01800Y FEIRCING C1 POOLI3PA - - ❑ LAND USE APPLICATION SrrES <br /> 0 MIDICAL WASTE FACILITY G PUBLIC WATER:aY5:-EM M 0TH9R(PLEASE$PraCIFY ABOVE) <br /> 1. List up to ten addresser,In the space above. Select the type(s) of files from the list above by checking <br /> the appropriate box(eg.). At least on*fila typo MUST be ;elected. Fax to t2a914 -0138 ar mall to the <br /> aAdrUS Infil(S�ialmd above. <br /> IEHD will notify the applicant If any EHO flies exist. An a 3pointment for review will be confirmed <br /> approximately five business days but no later than ton(le)days after racelpt of application. The files <br /> will be hold for a iTlaXimum of five business days for rev ow. Appointmanis Should be Scheduled <br /> accordingly. <br /> 3. A file that Is actively being worked on by Eho staff may not be Immediately available for review. A new <br /> application may be submitted when the flie is available, <br /> 4. Any file not returned in the same condition as released,vill be reorganized by EHD staff at the expense <br /> Of Ina applicant. Futuro fire reviews by the dame RPF,llei nt may require a $87.00 deposit prior to review. <br /> S. "TENTATIVE appointment dates must be confirmed With EH star[. <br /> 6. Applications receivod after 3:04 pm will be processed V a next business day. <br /> bONFIRMED APPOINTMENT DATE TIME <br /> _... <br /> #A7E CONFIRMED PHONE FAX INITIALS <br /> ., EVIEWED YES NO REV16w DATE <br /> k 90 16 0V9hC0 T' EV <br /> TOTFIL7 P.01 <br />