Laserfiche WebLink
—f2/00/04 MON 15:28 FAX 415 51, 5480 TE TECH EM INC SF Q10 <br /> PATE RECEIVED - EHD LOG NUMBER <br /> \V SAN JOAQMN ouNTY <br /> -_; � ENvrRoNmENTA.L HEALTH DEPA.>�TmENT <br /> '�IL( { 30413 Weber Ave aro Moor Stockton, CA 95205 <br /> DEC 6 2004)468-3420 Fax: (209)464-0138 Web:www.co.san-joaquiricaus/chd O �� <br /> I:L I , rUBLTC RECORDS RELEASE A-PPLICATION ( J <br /> ��R%�'J✓QBVSD4ESS1AGEHcv: <br /> ADDRESS: �"� I? /Oy00(l J % ! �O.S _'�I .�,•��-•. <br /> PHONE: I -a ! _ 7S FACSIMILE: 715 5 <br /> TENTATIVE;APPOINTMENT DATE; Tlmo: TF <br /> _–iJVtMIIJ L7L7��r D <br /> (Pleaso allow 10 buminess days from date of appffoaGon submlttall <br /> Q CHI=CK BOX TO EXPEDITE REQUEST-59 A 9ROCEa D IN 3 BUSINESS DAYS - j - <br /> SIGNATURE OF'APPLICANT DATE 0 <br /> Department Use Only <br /> FILE ADDRESS - UNIT <br /> N ?w R . u.aclr C G}� �9rS 3 ❑ Unit t <br /> z. svkL <br /> OA o. saee 0 W �L>til n ❑ ��L.^ GY!' 9S1 Yo <br /> Nii .. saen - VV7ue� ❑ Unit <br /> t ' s. saes <br /> s N -rr r'Z Yo <br /> -,:'- 5Unit 4 <br /> IIWIVc e. Sae., .5 .Gla GC+' <br /> s sane a V/ O ❑ Unit 5 <br /> ai N �L06) <br /> �M RONMENTAL HEALTH DEPARTMENT FILES Z E <br /> I� NOEROROUNO TANK NST1 CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT 13 SOLID WASTE FACILITY <br /> D QTHER CLEANUP sfrE(NONI.OP) ❑ FOOD FACILITY 0 SOLID WASTE VEHICLE <br /> L9��INDERGROLIN TANK(MONITORINGIREMOVAL) E3 DOG KENNEL tl DAIRY Ii! <br /> 6Y HAZARDOUS WASTE GENERATOR t7 CHICKEN RANCH tl PKG TREATMENT PLANT <br /> 13 TIERED PERMITTED FACILITY 0 MOTEUHOTEL 11 PUMPER TRUCMARDlCHEM TOILETS <br /> 0 TATTOOMODY PIERCING D POOUSPA 0 LAND USE APPLICATION SITES ✓ <br /> 0 MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> 1. List up to ten addresses In the space above. select the typo(s)of flies from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(209)464 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 (1 D)days after receipt of application. The files <br /> will be field for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. Afile that Is actively being worked on by EHD staff may not be immediately available for review. A now <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$93.00 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 /> Lf7NFIhMECI Pd IN MENT•DAtE s TIME <br /> iTATECDNFIR1Nk�U PHONE . FAX INITIALS <br /> 'At MEWED YES NO REVIEW DATE r <br /> ' M.AMVAm4 <br /> reyue5f -pP CLHU <br />