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07 O❑ 03. 33p t i <br /> 05-05- f1 :w.Fr) �FI�a1 14] <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERV(GE3 <br /> ENVIRONMENTAL NTAL HEALTH DIVISION <br /> F 304 EAST WEBER AVENUE,THIRD FLOOR ��� � 7 Zd�� <br /> STOCKTON CA 95202 <br /> A (209)4G8-3.120 <br /> PUBLIC RECORIDS RELEASE APPLICATION ENVIRONMENT HEAL:i'! <br /> �MTI(z "CFS <br /> i <br /> PuuiN1 - f-f,S !/1 2 /$i1slN�ssl1aGEH(C�Y 4�nrE/l,rnarK.,7scs/ S�I wC� .SerUi`[� <br /> ADDRESS��J <br /> iIYATIVE-APPoIHrM:Nr aATI= f Z <br /> (Phase p:rc 3 to 10�Ma�nes TIIiIE <br /> s ata strain dale a►a t' 41' a.. <br /> PA+Wtion sUhtttktall `+�;,..�_�i <br /> 7CNECK BQX TO I~I(PE017@ REQUEST- Wo0 F -REQU F CESSeo ISL 3 BUSINESS DAYS <br /> 51Gt4ATURE OF APPLICANT <br /> DATE 7 ' <br /> s <br /> FILE A¢DnRE$5 fms 510E t HD 5TAFF USE ONLY <br /> y PROGRAM ELr-kW YS SFARCH <br /> er <br /> a rJtJ F r IG Lo 1 358K <br /> ENVIRONMENTAL HEALTH DIVISION FILES ,. <br /> UNDERGROUND TANK(UST)CLF-ANup sITF(Lots) m mo"WC ADAT&Iaru r SOLID WASTE EACIL,ITY {JI <br /> XOTHER CLEANUP S)Tt:(F ON4-OP) 0 FOOD FACILITY O SOLID WASTE VEMQ tr ! <br /> UND£RGROUNDlAm(M0NrroRjsGjREmo,4A.L) R DOG KENNEL DAIRY <br /> r La "AZARj00U5 WASTE GENERATOR ❑ C"ICKFN RAMCH O❑d rD PERMITTED FACIITV � IO7t;L E7_PKG TREATANT PL4AT <br /> TADyDAG:ING 0 PUMPER TRUCKJYAR=N <br /> EMTO <br /> ILES <br /> EOICAL WASTE FRCfLrT7 3POOUSPA 0 LAND USE APPLICATION$rMS <br /> ❑ PUBLIC WATER SYS'T'EM O OTHER{PLEAS:SPECIFY ALIOVE) <br /> 1. Liat up to ten addm sas in Cho space above. Select the type(5)OT fifes from U18 ti5t above by eheckiN <br /> the appropriate box(es). At least one file type MUST be selected. Fax to 2OS 4 {)t3 ttlail the <br /> ad ass Ind sated above, .� <br /> 2. Em!)Will notify ttw 2111311Ca3nt if any 0W files exist. An appointment for_Iew will de contlrmea <br /> approximately five businass days but no later than ten(10)days after receipt of appTicalim The files <br /> Will be held for a maximum of fiva business days 10r raYleW. AppWrnbnentS should be scheduled <br /> accordingly. <br /> 3• A Ella that is actively being worked an by ItHD Staff rtlaty Opt be immediately availabre for review, A now <br /> 0151ic3tian may tae Submitted vMen the file it alvallable. <br /> a. Any We acct routed in th;same condition as reteased W!11 be reorganized by EH0 staff at the*xpar,x• <br /> Of the applicant'. Future tate reviow4 by the Sarna appllcatit may require a STS.OtI deposit prior to review. <br /> 5- "TENTATIVE appointmOntdateS must be clonfirmed with ENI)staff. <br /> fi. Applicat,ons received aftsr 3,00 pm will be processed the Ilnext business day. <br /> CONFIRMED APPOINTMENT DATE � _ _ TIME <br /> LATE CONFIRMED PHONE FAX INITIALS <br /> REVIE1 VED YES [IQ REVIEW DATE <br /> w 14 9]'7400# <br />