Laserfiche WebLink
04/24/2006 10:05 209-579-"25 MODESTO ATC PAGE 02 <br /> EHt)LOG NUMBER <br /> SAN dUAQUIN COUNTY 350 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> APR 2006 304 East Weber,Avenue,P Floor,Stockton,CA 95202-2708 <br /> hd <br /> Telephope• (209)468-3420 Pax:(209)464-0138 Web:www.$j90v.0r9/C <br /> ENVIRONMENT HEALTH <br /> .p,ERMIT ICES PUBLIC RECORM RELEASE ApgLICATION <br /> SUSINESSIAGENCY: <br /> ApPuCANT: <br /> ADDRES3: ` FACSIMILE:_ilml — <br /> PHONE(1): PHONE(2), <br /> TENTATIVE"APPaK McHr DATE: <br /> (PI"a allow to bueln*"d*Ya from 0010 of a p1"on submit..!-"Tvr►taPhro only-muet Da oor+tl <br /> [3 CHECK s0X To EXPEPITE REQUES -1e�00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 Slf$INESS DAYS - <br /> ,. I)ATE :�2 <br /> SIGNATURE OF APPLICANT �� <br /> UNIT DISTRISUTION 0 Unh 1 <br /> O Unit 2 Unit 3 13 UnI!s Unh 8 fl Other(ele�ontc111ab'��) <br /> FILE ADDRESS EHD USE ONLY <br /> stns a sbvot Name city <br /> 2. <br /> 3. <br /> 4. <br /> T. 7y ` <br /> 8. <br /> 9. <br /> 10. <br /> specific Date Range of Informatlon Requested:From <br /> to <br /> ENVIRONMENTAL.HEALTH DepARTMENT FILES <br /> UwomeFtouma TANK(UST)CLEMUP SITE(LOP) 0 Houma ADATEMIXT Wk O$OLV WASTE WASTTIREFAPLIT N9WL1 <br /> 0MR CLEANUP Sme(NON-L� nY <br /> 0 POW FACI� <br /> F <br /> UNDTANa<(MONiTOR1NvlREMOVAL) 0 D�KENNEL 0 DA RY <br /> ST$WAssE GENERATOR t7 CKcKEN RANCH 0 WA$7EYVATER TREATMENT PIJUNT <br /> RED Pt RMti1 PJR Fwclurr 0 MOTEL.Mom 0 PUMPER TR XWYARDICHEM TOELEsa <br /> C!TAT 0010 DY Pa<RCINa []ppoLISPA LARD USE I1PPuu►Txa+SITS <br /> ?O MEocAL WASTE FACILITY 0 OTHER(PLEASE SPECIFI� <br /> WELL AND SEPTIC PERMIT RECORDS ARE AYAILARS FOR REvIew- MONDAY•FMDAY 8:00 AM.5.-ooPM - EatcW=a HOLIDAY& <br /> 1. List up to tern addresses In the space above. Select the type(s)of files from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail tpthe address <br /> IngleWpdabove. Address rangy will not be accepted—for additional assistants with file addrawas,contact <br /> the EHD.Applications received after 3:00 pm will be processed the next business day. <br /> 2. The EHO will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately ten(10)days after receipt of application. The files will be held for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A nOIN <br /> application may be submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will be morgantzed by EHD stuff at the expanse of the <br /> applicant. Future file reviews by the same applicant may requite a$93.00 deposit prior to review. <br /> r <br /> END 4!42.000 <br /> 1114" <br />