Laserfiche WebLink
I `A41cuU4 16:13 FAX 209 9480821 <br /> c__ _J�DAxE RECEIVED _ SAN <br /> T :# 002 <br /> Fr QUIN COUN T x G <br /> D J ENWRONMENTAL HEALTH DE <br /> PA <br /> RTMENT <br /> 304 E Weber Ave 3rd Floor Stockton, CA 95205 <br /> .JUN 14 20x409)468-3424 Fax: (209)464..0138 Web:www.w.sanjo uin.ca.us/ehd <br /> BVIRUPvPIIENT !fit ALTRI PUBLIC RECORDS RELEASE APPLICATION <br /> C i <br /> APPLICANT: <br /> el ,vBUSINESSIAGENCY: <br /> ADDRESS: 01715 S <br /> PHONE: D J? FACSWILE: <br /> TENTATIVE*APPOINTMENT DATE to �l? 0 3 �'c <br /> (Please afiow 10 business days from date o{application s6bmittag' <br /> CHECK SOX TO EXPEDITE REQUEST;.$93.00 FEE—REQUEST PROCESSED IN 3,BUSINESS DAYS <br /> SIGNATURE OF APPLICANT <br /> DATE 6 /FO <br /> Departrne Use Only <br /> FILE ADDRESS it UNIT <br /> 1. Street V01 GI <br /> 70, <br /> - .s," 1 5 ke// 5 a %- a Unit 1 <br /> a. s+�1 b Sc LcR,r/ Lo,t? aG • ti o r(�7. �/ <br /> ,. street D F" Al Sill-e LD Unit 2 (rr <br /> s. se�eet 00 1/rcfo! a tlnit3 �d ') <br /> s• street I�G E ueexy �o <br /> y}� �• sveet � S �u Unit 4 <br /> e, stxtCity <br /> f o Rey <br /> Lo <br /> 9. shed (v0 GLV aty P "` - - <br /> ❑ Unit'5 <br /> 10. Street <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES , <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT L sOL jo wAsTE F A <br /> ,19 OTHER CLEANUP SITE(NON-.OP) ❑ FOOD FACILITY KSOLID WASTE VEHICLE <br /> it <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL i E3 DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH PKG TREATMENT PLANT <br /> ❑ TIERED PERmrTTED FACKM A MOTELIHOTEL ° PUMPER TRUCK/YARDICHEM TOILETS <br /> O TATTOOISODY PIERCING ❑ POOL/SPA i b LAND USE APPL3CAmoN SITES <br /> ❑ MEDICAL wASTE FAca ny ❑ OTHER(PLEASE SPECIFY) <br /> 'i. 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 seledted. Fax to-(209)464-0138 or mail to the <br /> address indicated above. -� <br /> 2. EHD witl notify the applicant If any EHD tiles 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. . jI <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. p <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$93.00 deposit prior to review. <br /> 5. *TENTATIVE appointment dates must be confirmed with EHD staff.. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> -� NFA 'iV[ED.''".�OINTM NTS "l N': _ <br /> R... AP E ATS''. ' .-TIME <br /> i]ATE'CONFIRME[) ' '. . f'p}(ONE - fAXNIEALS :_� ` <br /> ENIE D' -YES .140 REVIEW DATE <br /> E!W id-G2-006 . <br /> h 9 K i <br />