Laserfiche WebLink
:* TO'RDUd -11d101 >K* <br /> _,,,,��• tNV INUNMtN I AL HtA� PAGE 02 <br /> SAN JOAQUIN COUNTYPUEILIC HEALTH SERVICESMIDENVIRONMENTAL HEALTH <br /> ON <br /> IFI l.� ELI1�J/V) 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 9$202 <br /> JAN 15 2003 (209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> b� �Gtq� <br /> ' FIS H a BUSINESS/AGENCY_ S Z <br /> ADDRESS <br /> PHONE L � FACSIMILE 3 <br /> TENTATIVE APPOINTMENT DATE p�Lclata <br /> TIME I►l rn1n ��(�_D �,/(i(Pleasa give 7 to 10 bu inesaplication submittal) —► / <br /> CHECK BOX TO EXPEDITE.REQ <br /> VEST-389.00 FEE E?QUE5T PROCESSFD IN 3 BUSINESS DAYS un) <br /> 'SIGNATURE OF APPLICANT DATE <br /> FILEADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> 00 J v 1z. <br /> N. i sl ` <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY O SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL. O DAIRY <br /> ❑ HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG.TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY' ❑ MOTELIHOTEL ' 13 PUMPER TRUCK/YARD/CHEM TOILETS <br /> 0 TATTOO160DY PEIRCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> O MEDICAL WASTP FACILITY D PUBLIC WATER SYSTEM 0 OTHER(PLEASE SPECIFY A60Viz) <br /> 1. List up to ten addresses in the space above. Select the type(s)of riles 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 fiva 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 new <br /> application may be somitted when the file is available. <br /> 4. Any file not returned in the same conditlon 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$89.00 deposit prior to review. <br /> 5. "TENTATIVE appointment dates must be confirmed with EHO staff. <br /> S. Applications received after 3:00 pm w111 be processed the next business day. <br /> I <br /> CONFIRMED-APPOINTMENT DATE TIME, <br /> DATE CONFIRMED PHONE FAX INfTIALS <br /> REVIEWED YES NO REVIEW DATE <br /> sev.atn,zns, <br /> TO/TO'd 8ETOb9b60ET 01 dd 80:ET 200E ST NUE , <br />