Laserfiche WebLink
NDOR EARTH TECH 209 532 0773 P.01i0: <br /> SAN JOAQUIN COUNT[x is EHD LOG NUMf <br /> ENvnzoNmENTAL HEALTH DEPARTMENT <br /> 0 C T <br /> 12 2004 • 304 E Weber Ave 3'd Floor Stockton, CA,95205 <br /> (209)468-3420 Fax: (209) 464-0138 Web:www.co,san Joaquin ca us/ebd <br /> Z67Z <br /> E�� <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: ,Q / <br /> -2 <br /> J �^ 9USINESSIAGENCY: aN llZ9R '1 <br /> aj G �j f'T" / •1'7l WLR ' <br /> ADDRESS: Fp o K7(lY-r �./ .,/zsn N 2&1J�.- <br /> PHON ( AIO�. 0-10, t-51 FACSIMILE/�,,,�11 � �=,/Q <br /> TENTATIVE"APPOINTMENTS DATE: o2g Od o�octH Time: R AN <br /> (Piease allow 10 business days from date otappllmtlan submittal) <br /> CHECK 13OR TO EXPEDITE REQUEST-$93.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Department Use OrdY <br /> FILE ADDRESS UNIT <br /> L ATHTtO p Unit 1S <br /> i aeeei � <br /> a so-ee s' / UnR 2 a <br /> 4. Sf� Do Rb (D� <br /> s. sw, 1- 1 ' Unit a <br /> a $-..Aa �/ <br /> r. 8"M C?Iu ao Unit 4 <br /> e. suer <br /> 9, S~ ❑ Unit 5 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT �WSOLD WASTE ILRY <br /> OTHER CLEANUP SITE(NON-LOP) —, El FOOD FACILITY p SOLD WASTE VEHICLE <br /> UNDERGROUND TANK(MONITOMNGMEMOYAL) 0 DOG KENNEL r DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> pr TIERED PERMITTED FACILITY ❑ MOTELMOTEL ❑ PUMPER TRUCKIYAROICHEM TOILETS <br /> ❑ TAnoomODY PIERCING ❑ POOLISPA B LAND USE APPLICAT10N SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <br /> 7. List up to ten addresses in the space above. Select the type(s) of flies from the list aboye by checkin! <br /> the appropriate box(es). At least one file type MUST be selected. Fax to (209) 4640138 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 nei <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 expens, <br /> of the applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to reviel <br /> S. 'TENTATIVE appointment dates must be confirmed with EHO staff. <br /> 6. 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 /> TOTAL P.O. <br />