Laserfiche WebLink
r ftUt l : Geo-Phase Er ern r-or enta&�. FkX NO. : 2095690295 tar. 09 2001 0b:15PN F2 <br /> +`� <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> ,b� cfio�nCrwaatN <br /> ENVIRONMENTAL HEALTH DIVISION <br /> MAR 0 9 2001 304 FAST WESER AVENUE,THIRD FLOOR <br /> STOCKfON CA 95202 4 c�q <br /> +;'�1Vfs1�'T riEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> 468-3420 <br /> Pt _l, <br /> APPLICANT <br /> ADDRESS DRESS 13USINESSIAGENCY <br /> � <br /> PRONE © <br /> FACSIMILE <br /> POINTMENDATE <br /> tpiea%o give 7b!VE•APsays <br /> from tfate of appliestia n submivati <br /> WCK BOX TO ExPSOfrE REQUEST- <br /> x•00 FEE—REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT <br /> DATE <br /> FILE ADDflEsS <br /> G4►S' a � r �� �S z <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> IX UNDERGROUND TANK(UST)CLEANUP srre(LOP) D HOUSING ABATEMENT O SOLID WASTE FACILITY <br /> 13 OTHER CLEANUP SITE(NON.Lop} <br /> 14 UNDERGROUND TANK(M 13 FOOD FACILITY13❑ DOG KENNEL (3 SOLID WASTE VEHICLE <br /> ❑ HAZARDOUS WASTE GENERATOR DAIRY <br /> C3 TIERED PEPUMTTED FACILITY p CNKM RANCH E3PKG TREATMENT PLANT <br /> C3 TATrOOIBODY PEIRCING 0 MOTEJHOY9L ❑ PUMPER TRUCKIYARp/CHEM TOILE'S <br /> J MEDICAL WASTE FACILITY D POOLJSPA ❑ LAND USE APPLICATION SITES <br /> © PUSUC WATER SYSTEM D OTHER(PLEASE SPECIFY ABOVE) <br /> 1• List up to ten addresses in the space above. Select the type(s)of flies from the list aWve by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(209).t%tQj 8 or mail to the <br /> addreSS indicated above <br /> - <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 five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A fete 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 avallable, <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 flte reviews by the same applicant may require a$78.00 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 /> I=CONFIRMED APPOINTMENT DATE <br /> TIME <br /> DATE CONFIRMED PHONE FAX <br /> INITIALS <br /> REVIEVYED --�,--_ <br /> YES NO REVIEW DATE <br /> N 00 t� OilOSrOp <br />