Laserfiche WebLink
Dec 08 04 02: 37p Hanover Inc 530 342 1490, P. 2 <br /> d7—e7 cYJtJeJ vJo ii ., <br /> FJ/0 LO,+NJfdBER <br /> cArena �, �� Vel <br /> d JOAQUIN COUNTYPUBLIC HEALTH SERV ..ES <br /> ENVIRONMENTAL HEALTH DIVISION I ,n <br /> DEC $ ZOO4 304 EAST WEBER AVENUE,THIRD FLOOR <br /> ,�/ D E STOCKTON CA 95202 -zz <br /> (209)468-3420 <br /> 'rl �lbll �t `y <br /> PFS v I� 'TUBL IC RECORDS RELEASE APPLICATION <br /> APPLICANT Lana 3 1aC4�, BUSINESSIAGENCY <br /> ADDRESS, f�asaiiUe2r <br /> PHONE y1:.�, . :5q7. � `,5`5 FACSIMILE �34 I O <br /> TENTATIVE`APPOINTMENT DATE 1211�10 _ TIME . <br /> (please give 7 to 10 usiness days from date of application aubmlttat) <br /> Q CHECK BOX TO EXPEDITE REQUEST-587.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT 41 DATE — <br /> FILE ADDRESS IS SIDE EHO STAFF USE ONLY <br /> ROG ELEMENTS <br /> ylaj E. Fcmont <_+,, 5to�d �� r, u•Sr F�u� - <br /> ioz r.1. yin+aros I i= <br /> 2Ic30 Frc,mon S} <br /> 2a�°j E. t=rt,r•:cnF �F. U,ST 't-It <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> 1. <br /> `,UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT <br /> [1 SOLID WASTE FACILITY <br /> EyOTHER CLEANUP SITE(NON-LOP) C FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND YANK(MONCrOR1NGIREMOVAL) 0 DOG KENNEL ❑ DAIRY <br /> [ HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH ❑ PKO TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY D MOTELIHOTEL ,. ❑ PUMPER TRUCKIYARDICHEM TOILETS <br /> 0 TATTOO/BODY PEIRCING ❑ POOUSPA ' ' ❑ LAND USE APPLICATION SITES j <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM O OTHER(PLEASE SPECIFY ABOVE] <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checkin <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(209)464 0138 or mail[o the <br /> addressindi4ated above. <br /> 2. FHD 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 /> wi!�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 /> applic.vtion may be submitted when the file is available. <br /> 4. Any fiir; 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$87.00 deposit prior to review. <br /> S. "TENTA'(IVE appointment dates must be confirmed with EHD staff. <br /> B. Applicatiens received after 3;00 pm will be processed the next business day. <br /> CONFIRMED APPOI10TMENT DATE TIME <br /> DATECONFIRMED _ PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> FH Co ti 98 7190 <br /> _.__ TOTAL P.01... <br />