Laserfiche WebLink
MARCUS H. SOLE ASSOC 530 633 0119 09/22/03 02:56pm P. 001 <br /> Sat` AQUIN COU <br /> NTYPUBLIC HEALTH SE�k�TICES <br /> EII�I`OG XUYi6k <br /> i ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE THIRD FLOOR ' <br /> S E P 2 2 2003 STOCKTON CA 95202 <br /> 1r�:�.c1V-1 HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> r•;,; <br /> APPLICANT J S <br /> AOARESS BUSINESSIAGENCY <br /> d v Gv A�'"G <br /> PHONE0 3 — 3 t/ <br /> FACSIMILE IJ <br /> TENTATIVE-APPOINTMENT DATE <br /> S TIMES � _� .�7C� a9 . �-- 3 007 <br /> (Please Dive 7t0 t0 hushes%flays from data of appliaAtion svbmlli ,i) <br /> S <br /> CHECK BOX Tp E7CPEDrrtc REQUEST-=09.00 FEE REQUEST PROCES c) <br /> ,.� � <br /> SIGNATURE OF APPLICANT l.Z <br /> DATE 9 ZZ j �G'a � <br /> FILE ADDRESS THIS SIOE C•HO STAFF Use ONLY <br /> © PROGRAM ELEMENTS SEARCH <br /> N M <br /> LCRA14r w <br /> FNVIRONM!_NTAL HEALTH{DIVISION FILES <br /> wUHpERGROUhD TANK <br /> (UST)CLEANUP SITE(LOP) ❑ HOUSING ARATEMENT ❑ SOLID WASTE FACILITY <br /> ❑ OTHER CLEANUP SITE(NON-LOP) O FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> B'DNOERGROUND TANK(MONITORiNGIREMOVAL) ❑ DOG KENNEL D DAIRY <br /> Sar"HAYARDOUS WASTE GENERATOR ❑ CHICKEN RANCH O PKG TREATMENT PLANT <br /> 10 TIERED PERMITTED FACILITY ❑ MOTEL/HOTEL a PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑ TATTOOIBODY PEIRCING O POOL15PA ❑ LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY ❑ PUBLIC WATIER SYSTEM ❑ OTHER(PLEASE SPECIFYATIOVE) <br /> 1. List up to ton addresses in the space above. Select the type(s) of rites from the list above by checking <br /> the appropriate boxes). At least ono filo type MUST be setocted. Fax to(.209)464-0138 or mail to the <br /> address indicated above. <br /> 2. EHD wiJ1 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 available, <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$89.00 deposit prior to revlow. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> G. AppliCations received after 9:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT HATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REV[EW DATE <br />