Laserfiche WebLink
U.A'tE RCCEJVaD <br /> SAN JC ' IIN COUNTYPUBLIC HEALTH ICES E.-O LOG r;iX0.E� <br /> /2w 4 Ezvv►RONMENTAL HEALTH DIVISIOS <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> (209)4GS-3420 C <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT fv�a ri� 5 BUSLNE5S1AG1=NCY _ovkd pe IL.o-rj"j sLt livL(D to j Q5 r <br /> ADDRESS C38 �Yo rt k �s }- tai t-C�44 +� <br /> PHONE Z041 - 2.5 - OSt B FAC,S1�IllL1= 2C�°f - z3 n 5 3$ <br /> 17ENTATIVE*APPOINTMENT DATE 71ME <br /> (Phase give 7 to 10 businu=days from date of Application Submittal) <br /> CHECK BOX TO EXPEDITE REQt)EST-$87.DO FEE-REQUEST PR CE54�_D IN 3 BL15LNESS DAYS <br /> SIGNATURE OF.APPLICAN`F' � � DATE <br /> FILE AIDDRE55 THIS SIDE EHD STAFF USE ONLY <br /> �w PROGRAM ELEMENTS SFARCH <br /> n drool -,Z Z'667 <br /> +►Vlisri Mldd4L SJ XA r Ito, t. <br /> 4Ag1 W <br /> /. <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> GI t-]NDERSROUND TANK(U"CLEANW SITE(LOP) 0 HO=NG ARATEMENT C] SOLM WASTE FAGILM <br /> C OTHER CLEANUPSrrE(NON-•I.OP) 11 FOOD>=ACUJTY Cl SOLID WASTE VEHICLL <br /> 9' DERGROUNDTANK(MONITORMCIREMOVAL) C DOG KENNEL CRY <br /> L++" HAZARDOUS WASTE GENERATOR P-C-IiICXEN RANCH 17 PKG TKFATMENT PLANT <br /> ❑ TIERED PFS 11TTED FACaJTY 0 MOTELIHOTEL a PUMPIER TRUCKIYARD/CHEM TOILETS <br /> l f TATT041E30DY PGIRGING ❑ POQi-/SPA -- , Q LAND USE APPIJCATION SITES <br /> MEDICAL WASTE FAC{LJTY ❑ PU13 JG WATER SY5TE84 Ci OTHER(PLEASE SPECIFY ABOW) <br /> 1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(209) 46"138 or mail to the <br /> jjddm$ss 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 fivo 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 availabia. <br /> 4. Any file not returned in the same condition as released will be reorganized by END 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 /> 5. `TENTATIVE appointment dates roust be confirmed with EHD staff, <br /> 6. Applications received after 3:00 prn will be processed the next business day, <br /> CONFIRMED APPOINTMENT DATE - _ TIME <br /> ,DATE CONFIRMED PHONE FAX INITIALS <br />