Laserfiche WebLink
09/17/2003 09:36 FAX 209 948060 <br /> - Z002/004 <br /> are aFeo . <br /> 7'Fr" SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES eNaLOGNUNOEA <br /> rD <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR fqq7 SEP 1 7 2003 STOCKrON CA 95202 <br /> (209)468-3420 <br /> IVIr i)NMENI HEALTHPUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT BUSINESSIAGENCY <br /> 1 tif�L-�Ir, <br /> ADDRESS <br /> PHONE -2L) 1IaKfl/ )TNS FFACSIMILE ?-09bNS/U6 �—I <br /> TENTATIVE'APPOINTMENT DATE -( ��V TIME /ZCIO <br /> (Please give T to 10 buslness days from date of applimtIon subm tial) <br /> CHECK BOX TO EXPEDITE REQUEST.4 T.00 F -REQUEST PROCESSED IN 3 BUSINESS DAYS ' I <br /> SIGNATURE OF APPLICANT DATE IA-ie-IUD (_ <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTSSEARCH <br /> Z3 t Tv A "!" <br /> L I,-_I,E <br /> Wb I M L u Si. ti v t <br /> -- <br /> 40 coon , , <br /> L, <br /> — pp rr �I 11 lr <br /> I Inn <br /> tp stfl �� IV �J li rr I <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> 6b UNDERGROUND TANK(UST)CLEANUP SITE(LOP) U HOUSING ABATEMENT M SOLID WASTE FACILITY I` <br /> Q OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY - ❑ SCUD WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL M DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH W PKG TREATMENT PLANT <br /> ❑ TIEREDPERMMEDFACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑ TATTOOIBODY PEIRCING ❑ POOL/SPA .. 0 LAND USE APPLICATION SITE$ <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses In the space above, Select the type(s)of fifes 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 mall to the <br /> addresslndicated 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 new <br /> application may be submitted when the file Is avallable_ <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$a7.00 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 DATE TIME,. <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO - REVIEW DATE <br />