Laserfiche WebLink
05/01/2003 07:43 7146711008 ESS PAGE 32 <br /> 1�4� 564813- try+truivrvuvi n� ��•-^, s���uy.yrei`it <br /> j�; �[i; • SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMEN <br /> MAY 0 1 2003 304 EAST WESER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> (209)468.342D <br /> Ff iA)IkUP,t,A'iEi`: NEA!TH PUBUC RECORDS RELEASE APPLICATI'OP( <br /> rr...•r rn� ^CC .e.�•v..aez�....� .� <br /> �I <br /> (APPLI ANT.-_ 14,1714/w evSINESSIAGMW 60 yW007 . ._ ?L� e/ <br /> ADDRESS a-7vo Ct-01 -r 911tf ea.i CA <br /> PHONE 7/ (,271-19-1c; FACam, 7 �- O — <br /> TENTATIVE"APPOINTMENT DATE TWE -- 5� f'Z) <br /> (please give 7 t;10 tw4lne9e ftA from dete of sPOOMIM submIMPAj Un <br /> , N <br /> CHECK BOX TO EXPEDITE REQUEST-109.00 FEE-RE !ST PROCESSED M f BUSINI:34 0,hr-l' U`' + J <br /> +SIGNATURE OF APPLICANT !1. ----- DATE --5--��----- <br /> TSL )PR?T�.I;Ai=U:tE ONLY �I <br /> FILE ADDRESS PIMR11 ELEWENT6 SEARCH <br /> 0 0 mer — -- <br /> �I <br /> _/ ENVIRONMENTAL HEALTH DIVISION FILES <br /> `p UNDERDROUND TANK(us1h CLEANUP SITE(LOP) ❑ HOUSIHG AEATEWINT o $01.11)WAr•TR ITM:ALITY <br /> OTHER CLEANUP SITE MON-LOP) 13 FOOD FACILITY ❑ 4"L91 WA!TE VEhiICLIE <br /> UNDERGROUND TANK(MONITORING/REMIOVAU O DOG KENNEL tl D/iaarr <br /> HAMOOUS WASTE OEHERATOR C CHICKGN RANCH ❑ PrSa'114sA-naaHTPLAHT <br /> TIERED PERMITTED FACILITY O MOTELMOTEL O FLntr'SR T,eUCKIYARDICNas1 TOILET) <br /> O TATTOOIBOUYPEIRCING Cl FOOL/EPA ❑ UINO USE APPLICATION 61713 <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) — <br /> ,-1. List up to ten addreasss in the space above. Select the type(s)of files from t11 a Ilnt tlbove by aheck(ng <br /> the appropriate box(es). At least one fits type MUST be selected. ]I?� 14� 0( SQL 1Ul y.-tm <br /> address lndicated above. <br /> 2. EHD will notify the applicant If any EHD files exist. An appointment for revlevf will b,e confirmed <br /> approximately Ilve business days but no (atcrthan ten (10)days alter n'tlp1111' <br /> AUldlif plI SChadUl The <br /> WIN be hold for a maxlmum 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 immadlaWily aYaiMl:bin foe review. A nerve <br /> application may be submitted when the file)s available. <br /> 4. Any fib not returned In the same condition as released will be reorgsnl;:ed by E_HD otaff at the aKpormo <br /> of the applicant. Future file reviews by the rime applicant may require s ?89.00 deposih prior to review. <br /> 5. 'TENTATIVE appointment dates must be corlfIrmed with EHD staff. <br /> e. Applications received After 3:00 pm will be processed the next bunlnesa day. <br /> CONFIRMED APPOINTMENT DATE _ __ TIM! -- <br /> DATE CONFIRMED PHONE FAX Ipf1IALP I� <br /> REVIEWED YES NO REVIEW DATE <br /> «. <br /> Yxvmor <br />