Laserfiche WebLink
03/22/2000 13:20 15033622446 YAMADA PAGE 02 <br />63;22/2000 11:18 26946 33 FIFTH -10OR r•a��t n.: <br />daSlase, a <br />E STN JOAQUIN COUNTYPUBLIC HEALTH SEI�'`JICES <br />ENVIRONMENTAL HEALTH DIVISION <br />MAR 2 3 2000 304 EAST WFEIER AVENUE, STOCK ON CA 95202 THIRD FLOOR // <br />(209) 468.3420 <br />ENV!i ON iVEN t ~�ALTt; <br />FI PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT 3 LIC Y/}6A �'n/ 1 G-rtBUSINESSIAOLINCY <br />ADDRESS /W `� 7 �TL� 503-3,6 <br />PHONE h-�62—ZO FACSIMILE_ 03-362 - z�4b <br />TENTATIVE" APPOINTMENT DATE TIME l i R i N_ 1, 2fXY� 10:36 s e <br />(Pfaase piw 7 to TU busheu days from ate at appScatiOn submiaap � <br />MAR "r 3 <br />CHECK BOX TO EXPEDITE REQUEST - STB.00 F!�!fREQUkST PROCESSED IN 3 e1JSINESS DAYS <br />SIGNATURE OF APPLICANT -�� ___ DATE `Z2 —2-00 Q <br />1% SIDE EHD STAFF U <br />FILL ADDRESS 1,41%SE NLY <br />PROGRAM ELEMENTS SEARCH <br />( U 2 mGL C <br />- - <br />U <br />- -U3 <br />ENVIRONMENTAL HEALTH DIVISION FILES <br />-VUV <br />X—C <br />TANK (UST) CLEANUP SITE (LOP) O HOUSING ARATEhIENT ❑ SOLID WASTE FACILITY <br />gTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br />,ACUNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOO KENNEL ❑ DAIRY <br />❑ W12AR000S WASTE GENERATOR In CHICKEN RANCH ❑ PKD TREATMENT PLANT <br />❑ nelteC PERMITTED FACILITY 0 NOt.UHOTEL ❑ PUMPER TRUCKriAPMCHEMTOILETS <br />❑ TATTOO/BODY PEIRCING n POOVSPA ❑ LAND USE APPUCATION SITES <br />17' MEDICAL WASTE FACILITY InPUBLIC WATER SYSTEM ❑ OTHER (PLEAS! 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 t0{91 1 4p4.0138 or mail to til@ <br />riAress Indlcated abovat, <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) dayaof ter receipt <br />t of applicshould be schedule <br />Tgd files <br />will be held for a maximum of five business days for review. App <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 reorganited by EHD staff at the expense <br />of the applicant. Future file reviews by the same applicant may require a $78.00 deposit prior to review. <br />5. 'TENTATIVE appointment data$ must be confirmed with EHD staff. <br />6- Appllcatlons received after 3:00 pm will be procacssd the next business day. <br />I I <br />CONFIRMED APPOINTMENT DATE TIME <br />I <br />DATE CONFIRMED PHONE FAX INITIALS <br />I V=VIF:W1;n YES NO REVIEW DATE <br />