Laserfiche WebLink
VNI t Ktl.C1Y CV SAN JOAQUIN COUNTY <br /> ENVI&NMENTAL IUALTFI DEPARTMOT <br /> /�w <br /> 304 E Weber Ave 3rd Floor Stockton, CA 95205 <br /> MA0�09)468-3420 Fax: (209) 464-0138 Web:www.co.san-joaquin.ca.us/ehd <br /> lZo <br /> "11111 PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:'_�)E7CEI7 l A,ow ,j o2�:2 BUSINESSIAGENCY: <br /> ADDRESS ���(7-� -"�1-N- <br /> PHONE: <br /> FACSIMILE: �f�'C7— <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application 6ubmittar) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST- 9 .00 FEE-REQUEST PROCESSED IN 7 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATES <br /> Depadnwrd Use Only <br /> FILE ADDRESS UNIT <br /> Unit 1 <br /> 2. seM �- Z S a,.��u �E 2��`11LY3i+rJ t— <br /> �� Irl.6�n— Unit 2 Gr � <br /> a. seen <br /> ui. <br /> a. seer SS6 1 - 1 <br /> s. seen <br /> Unit 3 <br /> 6. Seeel 1A n <br /> r. sacci <br /> Unit 4 <br /> 6. S& <br /> Unit 5 <br /> w. Se <br /> / ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 0-UUNDERGROUND TANK(UST)CLEANUP SITE(LOP) ClHOUSING ABATEMENT El SOLID WASTE FACILITY <br /> 11'OTHER CLEANUP SUE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> 153�914DERGROUND TANK(MONRORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> [ 'HA7MDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> BATTERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑ TATTOOBODY PIERCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <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 to(209)464-0138 or mail to the <br /> address indicated above. <br /> 2. EHD will notify the applicant R any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10)days afterreceipt of application.d be n T led will be held for a maximum of five business days for review. Appointments <br /> accordingly. . <br /> 3. Afile 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$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 /> CONFIRAPAOINTME.NTDATE TIME <br /> MED <br /> f)ATE CONFIRMED PHONE': FAX'' INITIALS <br /> REVIEWED - YES NO REVIEW DATE <br /> ' EHD{8�2-0e6 <br /> 6rtrz001 <br />