Laserfiche WebLink
10-4k-2030 092�'art F TO 4154535661 P.02 <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> SENVIRONMENTAL HEALTH DIVISION <br /> $ 304 EAST WEER AVENUE.TI--IRL)r-lJOOF? <br /> ill' <br /> STOCKTON GA 95202 <br /> (20U)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> PHONE <br /> TENTATIVC'APPom-rmEN T DATE iJ LJ <br /> A -'ii <br /> IPIQUq 9i"7 1410 hkjsincsa days Ircrn dale of appl;cal' <br /> Xc"ECK BDX TO EXPEDITE REQUEST-$S5 .P0 FEE-REQ ST PCESSrPR aD'N I BUSINESS DAYS <br /> _ <br /> SZGNA-1UREQFAPPLICANT DATF. <br /> I it <br /> nLe ADDRESS (Aa -STOCKIN4- THIS SIDE END STAFF USE ONLY <br /> 10ROGRAMELtMENT.54EARCH <br /> I a- -5- <br /> -:3 L <br /> -2�7 aeliq Z, <br /> J41)6 <br /> .1 A <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> �UNDERGROUND TANK(USTI CLEANUP zi]TE(LOP) 0 HOUSING ABATEMENT 0 SOUD WASTE FACILITY d r) <br /> 07`NER CLEANUP SITE{NUN-LOP) 0 FOOD FACILITY D 506DWASTE VERICLE <br /> I? UNDERGROUND TANK(MONITORINGIREMOVAL) 0 COG KENNEL 0 DAIRY <br /> 13 HAZAROOUS WASTE GENERATOR 0 CHICKEN RANCH L7 PKQ TREATM5Wr PLANT <br /> 0 TIERED PFRIALTTE13 F;LC;i1-1Ty 0 moTELjmO'TFi- rl PUMPER TRUCIVYARINCHIENITOILEM <br /> 0 TATTOQEDDY PEIRCJNG D PWI15PA 0 LAND USE APPL[CAT*N SITES <br /> El MEDICAL WASTE FACALITY '0 PUBLIC VVATER SYSTE A 0 OTHER(PLEASE SPEC)"ABOVE) <br /> i List up to ten addresses in the space above. Select the type(-s)of fifes from the 14t ahWi&by checking <br /> the appropriate box(es)- At laaztone file type MUST be selected. Fax 1:6120914r>41-013tor mail to the <br /> addr%j$ r <br /> .L,LdicdIucj above <br /> 2. EHO will notify the applicant if any EHO files exist- An appointment for review will be confirmed <br /> appr6ximately five business days but nO later than ten(10)dayslaft-r 4ceipt of application. The files <br /> will be held for a Maximum of five businaz*days for review. ApOolntmftnts should be scheduled <br /> accordingly. k <br /> 3 A file that is actively being worKOCI on by EHO Staff may mit be idimedtately available for review. A new <br /> application may W submitted when the file Is available. <br /> 4. Any file not returned in the bafne condition as released will be rellorganUed by Elio staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a$B7.00 deposit prior to review. <br /> S. *TENTATIVE appointment dates must be confirmed wilh E40 staff. <br /> ff. <br /> 6. Applications received after 3:00 pm will be processed the .)W bisiness day- <br /> CONFIRMED APPOINTMENT PATE 'nmE :!1 <br /> DATE:CONFIRMED PHONE FAX 11 INITIALS <br /> �fTEV15WE-D YES No REVIEW DATE <br /> EH 00 zi pW1�pY <br /> ti TQTAL P,W <br />