Laserfiche WebLink
�TZ ! \ <br /> 10 Q002.ooa <br /> JC06161N COUNTYPUBLIC HEALTH SE EkO WGMWBlR <br /> ENVIRONMENTAL HEALTH DIVISION <br /> APR,3 Q 3"ST WEBER AVENUE,THIRD FLt <br /> STOCKTON CA 85202 <br /> 1E:NVM0"il AEN1* HEAL (209)468.3420 <br /> RECORDS I <br /> -^ I1BLlC DS RELEAS <br /> E APPLICATION <br /> APPUI <br /> Z--- BUSINESS/AGENCY �.- <br /> ADDRESS - <br /> r•�-G� S-f- <br /> PHONE_qqj;?^, / Gyp FACSIMILE <br /> TENTATIVE*APPOINTMENT DATE S/ 71a 3 TIM �,, © —•� <br /> (Please give T to 10 business days frnm date of applicatfon Gubmittal) <br /> 5-7 <br /> 13 CHECK Box TO EXPEDITE REQUEST•S8T.00 FEE-REQUEST <br /> REQUEST PROCESSED IN 3 BUSINF:aS DAYS', N <br /> SIGNATURE OF APPLICANT <br /> DATE cy O <br /> ELLE ADDRESS THIS SIDi:EHD s� ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> COtU"+ Ow TV✓ <br /> 0;l1pov <br /> T v..!-� Cff, 2 <br /> / ntr Il 1 OV.,•ir AA 7- <br /> Cl�..t 1✓ <br /> r7oOlitr ClVb / !vL/a6 1 <br /> S C'4+c. r C lv1 1 L <br /> —to NTT <br /> ENVIRONMENTAL HEALTH DMSION FILES <br /> •�u�+10 TANK(UST)CLEA14UP SITE(LOP) ❑ HOUSING ABATEMENT tl��SE►LIq WA:3TtE FAClLIIY <br /> > (N)N-LOP) ❑ FOOD FACILITY -a'stu_Ila WASTE V1F-4ICL.E <br /> G HAZAADOW F r1�R GIREMOYAL) Q OOG ICENRA p PKG �' <br /> CHICICEtI RANCH ❑ PKO TREATMENT PLANT <br /> O TATTOQIBOOIf PEIRCWG n MOTELIHOTEL 13PtiMPER TRUCK/YAROICHEM TOILETS <br /> E3PE3MEaDICAL WASTE FACILITY• ❑ PUBLIC <br /> LUIC8PY ATBii SYSTf.M O OTHF'R USE <br /> APPUCAIXIN SFM <br /> (PLEASE SPECIFY i%BOVE) <br /> 7. 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. a c t:o 209 464-0938 or nyaj1 tothg <br /> 4s indicatesf abvv <br /> 2. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> aPPMXk mtely 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 Wonted on by EHD staff may not be tmmediattlly c-Ivaiiable 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 expertise <br /> Of the applicant Future file reviews Ely the same alfpilcant may requir►:a$87.00 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 busing.-m day. <br /> CONFIRMED APPOINTMENT DATE —_ TIME <br /> DATE CONFIRMED <br /> PHONE FAX INITIALS <br /> REsV11=WED YES NO REVIEW DATE <br />