Laserfiche WebLink
SAN JOAQUIN COUNTYPU13LIC HEALTH 5tKV1Gkb 4+' <br />JIVIRONMENTAL HEALTH DIVISAft <br />4 EAST WEBER AVENUE, THIRD FLOINW, <br />FEB - 5 2001 STOCKTON CA 95202 <br />(209)488-3420 <br />=r,nnnnains: i PUBLIC. RECORDS RELEASE APPLICATION <br />BUSINESSIAGENCY <br />( o(U`ll -f 1'e /—/UU0 FACSIMILE G{ Z / /!O <br />TENTATIVE" APPOINTMENT DATE Cd &'10 aolm t�)TIME I D• O 0 <br />(Please give 7 to 1e bmIness days from dale of application submittal) <br />)P! CHECK BOX TO EXPEDITE RE <br />SIGNATURE OF APPLICANT <br />FILE <br />IN 3nnBUSINESS GAYS <br />DATE <br />ENVIRONMENTAL HEALTH DIVISION FILES <br />'Pd UNDERGROUND TANK (UST) CLEANUP SITE (LOP)�i HOUSING ABATEMENT 13SOLID WASTE FACILITY <br />OTHER CLEANUP SITE (NON -LOP) ( FOOD FACILITY O SOLID WASTE VEHICLE <br />UNDERGROUND TANK (MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br />HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br />❑ TIERED PERMITTED FACILITY ❑ MOTEUHOTEL ❑ PUMPER TRUGK/YARDIOHEM TOILETS <br />❑ TAT700MODY PEIRCING ❑ POCUSPA ❑ LAND USE APPLICATION S11ES <br />❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM Cl OTHER (PLEA5E SPECIFY ABOVE) <br />1- List up to ten addresses in the space above. Select the type(s) of files from the list above by checking <br />the appropriate box(es). At least one file type MUST be Selected. Fax to (209), 04-0138 or mail to the <br />address indicated above. <br />2. EHD will notify the applicant If any EHD 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 files <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 condition 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 $78.00 deposit prior to review. <br />S. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br />G. Applications received after 3:00 pm will be processed the next business day. <br />CONFIRMED APPOINTMENT DATE TIME <br />DATE CONFIRMED PHONE FAX INITIALS <br />REVIEWED YES NO REVIEW DATE <br />FH Do 14 Duosm <br />