Laserfiche WebLink
J;Tc RFC�Ea ENb LOG NUMaOt <br />�l SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br />VIRONMENTALHEALTH DIVISIOt <br />SO4 EAST WEBER AVENUE, THIRD FLOOR.... <br />T.., .� STOCKTON CA 85202 . <br />(209) 468-3420 <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT-4y4e' L . ELISINESSIAOfiNCY <br />ADDRESS �� �T6CA O/OFX�%C/.P'��L�/A� <br />PHONE jQ? SlIi7ZO FACSIMILE:�� <br />, - <br />Z�(�2 <br />Z Sg <br />TENTATIVE' APPOINTMENT DATE TWE ree—plye <br />(Please Giva 7 to 10 business days from datc of a4liwHnn submlUaq <br />17 CHECK BOX TO EXPEDITE REQUEST- $70.00 FEE - REQUEST PROCESSED IN 3 BUS1NESSDAYS <br />SIGNATURE OF APPLICANT S_-(�.L��_ DATE <br />ENVIRONMENTAL HEALTH DIVISION FILES <br />UNDERGROUND TANK (VST) CLEANUP SITE (LOP) <br />❑ HOUSING ABATEMBVT <br />0 SOLID <br />IOTHER CLEANUP SITE (NON.1.OP) <br />❑ FOOD FACILITY <br />WAASTE VEHICLE <br />-1 NDERGROUND TANK (MONITC RINGfREMOVAU <br />L3 DOG KENNEL <br />❑ DAIRY <br />❑ HAZARDOUS WASTE GeNERATOR <br />d CHICKEN RANCH <br />❑ PXG TREATMEWr PLANT <br />❑ TIERED PERMITTED FACILITY <br />O MOTFUHUTEL <br />Cl PUMPER TRUCKIYARDICHEM TOILETS <br />❑ TATTOOIBODY PEIMING <br />❑ POOLISPA <br />C] LAND USE APPLICAYION SITES <br />❑ MEDICAL WASTE FACnJTY <br />❑ PUBLIC WATER SYSTEM <br />❑ OTHER (PLEASE SPECIFY ABOVE) <br />1. List up to ten addresses in the space above. Select the types) Of files frytnt a by checking <br />the appropriate box(es). At least one file type MUST be selrrcted. Fax t (d 2091464.0138 a 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 END staff. <br />6. Applications received after 3:00 pm will be processed the next business day, <br />CONFIRMED APPOINTMENT DATE <br />DATE CONFIRMED <br />REVIEWED YES <br />TIME <br />PHONE FAX INITIALS <br />REVIEW DATE <br />TUTAL P.02 <br />