Laserfiche WebLink
I <br /> FM <br /> ��FR�M : NW f=nv i ronmenta 1 <br /> pHONE No. : 209 369 4228 Dec. 23 2602 12ENDVI AWMOER <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> STOCICTON CA 98202 q <br /> �,.��304 EAST WEBER AYr-NU1~,THIRD FLOOR <br /> 0�C 2 3 2002 (209)488.3420 <br /> .pPPLI,C RECORDS RELEASE APPLICATION <br /> APPLICANT Gf-� SUSINESSIAGENCY, -- <br /> 'ADDRESS Z2 <br /> PHONE Gr�- O( FACSIMILE ?� - Z�S <br /> TENTATIVE'APPOINTMENT DATE T� z Da 3 TIME <br /> (Pleaso give 7 to 14 5uslness days from data of applicatlon submittal) <br /> I r'1 <br /> r CHECK BOX TO EXPEDITE REQUEST-$09.00 FEE-RE STP OCESSED IN 3 BUSINESS DAUn <br /> SIGNATURE OF APPLICANT DATE <br /> r 2— <br /> FILE ADDRESS THIS SIDE EIiD STAFF USE ONLY <br /> PROGRAM MXMI;NTS SEARCH <br /> 0 061% <br /> s <br /> ENVIRONMENTAL.HEALTH DIVISION FILES <br /> E1 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT 0 SOLID WASTE FACILITY <br /> jr OTHER CLEANUP SrrE(NON-LOP) ❑ FOOD FACILITY to SOLID WASTE VEHICLE <br /> J• UNDERGROUND TANK(MONrrORINGIREMOVAL) 0 DOG KENNEL O DAIRY <br /> 0 HAZARDOUS WA57E GENERATOR 0 CHICKEN RANCH 0 PKG TREATME14T PLANT <br /> 0 TIERED PERMI-I TED FACILITY M MOTELIHOTEL 0 PUMPER TRUCKIYARDICHEM TOUX"T <br /> C1 7Ai'T001BonY PEIRCING 0 POOL/SPA 0 LAND USE APPLICATION SME5 <br /> 0 MEDICAL WASTE FACILITY 0 PUULIC WATER SYSTEM lR OTHER(PL 6A58 SPECIFY ADO <br /> EI •• <br /> 1_ List up to ten addresses in the space above. Select the types)of files from the list above by shacking <br /> the appropriate box(es). At least One file type MUST be selected. Fax to 209 X464-0138 or mail to the <br /> address indicated above. <br /> 2_ EHD will notify the applicant If any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than.ten (10)days after receipt of application. The files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> E accordingly. <br /> 3. A file that 15 actively being worked on by EHD,staff may not be immediately available for review. A new <br /> application may be submitted when the fila is available. <br /> 4_ Any file not returned in the same condition as released will be reorganized by EHD staff at the expense <br /> f of the applicant. Future file reviews by the same applicant may require a$B9.00 deposit prior to review. <br /> I 5. "TENTATIVE appointment dates must be confirmed with EHD staff. <br /> I <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> I <br /> ~ CONFIRMED APPOINTMENT DATE, TIME <br /> DATE CONF1ItME13 PHONE FAX INITIALS. <br /> sZr--vIEWED� YES I HO REVIEW DATE <br />