Laserfiche WebLink
06/22/2004 11:5.9 3037639 TECHLAW INC • PAGE 02/0 <br /> EHD LOG NUMBER <br /> DAT LO- <br /> IlVED" SAN JOAQUIN COUNTY <br /> }� ENVIRONMENTAL HEALTH DEEARTMENT <br /> JUN 2 2 2004 304 E Weber Ave 3.d Floor Stockton, CA 95205 <br /> (209)468-3420 Fax: (209)464-0138 Web: www.CO.9an joaquin.ca.us/ehd <br /> ENVIRONP'v9EiJT HEAD H <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: '"l ° �n h `n�- BUSINESSIAGENGY: �Q GCl w <br /> l7 <br /> ADDRESS: 5 q cy <br /> PHONE:, <br /> TENTATIVE"APPOINTMENT PATE: <br /> Time: <br /> (pleasa allow 10 Business days hem date of apPl)caticn Subm'dal) <br /> CHECK BOX TO EXPEDITE REQUESTA.$93.00 PEE—REQUEST PROCESSED INS BUSINESS DAYS <br /> DATE <br /> SIGNATURE OF APPLICANT Department Us Only <br /> 'hS UNIT <br /> FlLE ADDRESS ✓ <br /> ��12(f ID�JIa r, sueel O �. ❑ Unit 1 <br /> a X535 5 . Li °a <br /> �}, ✓ 40eUnit 2 <br /> a street SD S1 , <br /> a. Street U U ., C <br /> � S• L'n D UUnitU 'tel <br /> s sbee / <br /> 6, Street D �• C <br /> 3 9. Li cn ✓ Unit4 <br /> gM� � D <br /> s. street 0 U ✓ C <br /> 10. Street � <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 13 HOUSING ABATEMENT 0 SOLID WASTE VEHICLE uo WASTE v� ' <br /> OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY ❑ DAIRY <br /> �PCUNDERGROUND TANK(mowroRINGIREMOVAL) 13 DOG KENNEL 0 PKGTREATMENT PLANT <br /> HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH ❑ PUMPER TRUCKNARDICHEM TOILETS <br /> q TIERED PERMITTED FACILITY 0 MOTELIHOTEL p LAND USE APPLICATION SITES <br /> 0 TATTOOISODY PIERCING 0 POOL/SPA <br /> O MEDICAL WASTE FACILITY 0 OTHER IPLEASE 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 W(2091464-0138 ar mail to the <br /> address indicated above appointment for review will be confirmed <br /> 2. EHD will notify the applicant if any EHD files exist. An app <br /> approximately five business days but no later than ten (1o)days after <br /> receipt <br /> of applicshould be� heion. 'Ihe flies <br /> will be held for a maximum of five business days for review. App <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 Tile is available. expense <br /> 4. Any file not returned in the same Condition as released will be reorganized by EHD staff a e e ease <br /> of the applicant. Future file reviews by the same applicant may require a P prior <br /> 5. `TENTATIVE appointment dates must be confirmed with EH13 staff. <br /> the next business day. <br /> 5. Applications received after 3:00 pm will be processed <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> eue/e-aaace <br /> amrmm <br />