Laserfiche WebLink
14:37 9252836121 AEI CONSULTANTS (SF) PAGE 01 <br /> 39/19/2083 12:45 4640 ENVIRONbENT111_SrH PAGE 01 <br /> VATE RECEIVED _ Cnu t_w 111VIVIDCA <br /> SAN JoAQunv COUNTY . <br /> L EN vjmoNMENTAL HEA,LTS DE)?ARTmEn <br /> S P 2 2 304 F,Weber Ave 3rd Floor Stockton,CA 95205 <br /> 468-3420 Fax:(209)464-0138 Web:www.co.s=-joaquin.caus/chd <br /> ENVIRONMENT PUBLIC PUDDxC RECOP.DS RELEASE APPLICATION <br /> APPLICANT: 1 e, BUSIWSSIAGENC1f: ��. <br /> ADDRESS: d <br /> a � 1 C1re <br /> PHONE:_12:2 0� FACSIMILE- 4as- L - 67 j a <br /> TENTATIVE*ApP81NTMEtIYUATE:. " Tom: <br /> (Ph;ovc allow 70 business days from date of application submMol) ( nv' <br /> CHECK BOX TO EXPED RE LST, 93. FEE- U>✓S <br /> T PR0C);5s1=D IN;;DUSINESS DAYS V( <br /> - SIG�NATURI=OF APPLIC DATE <br /> ` <br /> Deparmwit use ONy <br /> FILE ADDRESS UNIT <br /> 1. street 101, ❑ Unit 1 <br /> 4 rat o � .. <br /> a. street S o o C) l at a Unit 2 a. <br /> stmt 1'Y-,ct Y11VI d� t� `c <br /> a ° r, Unit 3 <br /> 9. street <br /> Stmt Unit 4 <br /> 8. Street <br /> 9. sty ❑ Unit 5 <br /> 10. street CRT <br /> �n G+me : F+(�"c1n Ccx ern C�1 n tI 11 rl� kt s et ,/'l <br /> ENVIRONMENTAL HEALT DEPARTMENT FILES G`n v -k.)n s g/z-2 <br /> UNDERGROUND TANK(US7)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT �SOLID WASTE IFACIL17Y <br /> O*HER CLI;AMP SITE(NOWLOP) O FOOD FACILITY Q SOLID WASTE VEHICLE <br /> 4:0 <br /> UNDERGROUND TANK(MONITORINO/FtEMOVAL) © DOG KENNEL O DAIRY <br /> HAZARDOUS WASTE GENERATOR Cl CHICKEN RANCH O PKG TREATMENT PLANT <br /> d MO TEUMOTEL E3 PUMPERTRUCKIYARDICFIEM TDILETS <br /> TIERED MODY PED FACILITY 13 LAND USE APPLtCAT10N SITES <br /> TATTOO/BODY PIERCING Q POOLI3PA MEDICAL WASTE FACILITY O OTHER(PLEASE SPi:gFlf) <br /> �. List up to ten addresses in the space above. -Select the type(s)of files from the list aboye by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to Q9 4 or mail to the <br /> ddress indicated above. <br /> 2. EHO will notify the applicant if any EMD files exist.. An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10)days after receipt of application. The flies <br /> will be held for a maximum of five business days for review. 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 available. <br /> 4. Any file not returned In the same conditlon 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$93.00 deposit prior to reviem <br /> 5. 'TENTAtNE appointment dates must by confirmed with EHD staff. <br /> 6., Applications received after 3:00 prn will be processed the next business day. 1 <br /> CONFIRMED APPOINTMENT DA'T'E TIME l <br /> DATE CONFIRMED PHONE . FAX- INITIALS _� 1 <br /> REVIEWED YES NO t EVIEW PATE } <br /> env,iaavoe . <br /> Samos <br />