Laserfiche WebLink
AN ZIOAUUIN L;UUN• .• .U� u� <br /> J <br /> I YYUtiL{t: ti>;AL I�ti SGRViCES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBERAVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 V�j <br /> (269)4683420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANTvy r��tal.e ►vlt�avriJ sUsiNESstAGENCY GPotsrott!`L cowf«h...A �.. <br /> q <br /> ADDRESS 2 'I</`1/E/ln.N 5,r, frrZ/S ,t'rrFNs GA .9 <br /> PHONE 5d!- 26 Y- xS`3$" FACSIMILE rr zJ 1 <br /> i ; <br /> � <br /> 'TENTATIVE"APPomrmENTOATE 4/2 V-1,70 TIME Ly�Qrk_%yg RIM :i iv <br /> IPlease glue 7 to f0 4u5i4e days from date of appuwila submieal) ` f oN <br /> �1 F-' o b <br /> CHECK BOX TO EXPEDITE REQUEST.37$,00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> r a <br /> SIGNATURE OF APPLICANT • p DATE "" <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> G4:2 i2 0 <br /> w <br /> W ss ?f`Z(' <br /> r <br /> 'Ir POP MOAN wii In An <br /> tv 13`�l Z C <br /> � o <br /> I Q 000 00 <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) EJHOUSING ABATEMENT ❑ SOUD W E FACILITY <br /> ❑ UNDERGROUND TANK I ON TORINGIREMOVALI CI DOG KENNETHER CLEANUP SITE(NON-Lop) 0 FOOD L 11 DA LID WASTE VEH1Cl,f: <br /> RY <br /> ❑ HAZARDOUS WASTE GENERATOR M CHM:ICEN RANCH O PKG TREATMENT PLANT <br /> CI TIERED PERMITTED FACIUTY Cl MOTELIHOTEL 13 PUMPER TRUCK(YARDICHEM TOILETS <br /> ❑ TATTOO/BODY PEIRCItIG CI POOLMPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY D PUBLIC WATER SYSTEM ❑ OTHER(PLEA$E 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. Fg& o.(2091464-0138 or mail to the <br /> address indicaled above. <br /> 2. END 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 live 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 /> 5. "TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3.00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DA7E TIME <br /> DATE CONFIRMED PHONE FAX INMALS <br /> REVIEWED YES NO REVIEWOATE <br /> DI to �o a7<tamo <br /> TnTGIP 9t:)TOTAL P.02 <br />