Laserfiche WebLink
i <br /> 04/15/2002 14:56 2094F 1.18 AGE STOCKTON PAGE 01/91 <br /> DATE RECkIYEO E kJILI 4e�tu RUMl1tx <br /> SAN AQUIN COUNTYPUBLIC HEALTA"ARVICES <br /> ENVIRONMENTAL. HEALTH DIVISION' <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> (209)468-3420 <br /> a <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> :. <br /> 1 <br /> AAUCANT BUSiNESSIAGENCY U <br /> ADDRESS 3 Sha yj0 + <br /> PHONE RIO FAGSIMILF� 9 2 <br /> w,F <br /> TENTATIVE*APPOINTMENT DATE 9 0 11:� c� TIMlE <br /> (Please V 1 buss ys from to of app-cation submittal) <br /> �ok <br /> CHECK SOX TO EXPEDITE REQU T-� 8. 0 FI E T P I Bl)SINESS DAYS <br /> SIGNATURE OF APPLICANT DATE J <br /> FILE ADt)RESS <br /> �7 F. no <br /> Y Q'7 0 AIMS e It V s' c. <br /> 1A.0it f 3� 4 <br /> ggori <br /> Q W <br /> 3 S211r 5 <br /> /oZ l7 GC c <br /> _ . A ele <br /> IL <br /> 35 8 k .29 <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUNTANK(UST)CLEANUP SITE(LOP) ❑ HQU5ING ABATEMENT © SOLID WASTE FACILI Y <br /> n <br /> OTHER CLEANUP 917E(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNQERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNET- 0 ,DAIRY <br /> HAZAR00US WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> TIERF_0 PE=RMITTED FACILITY 0 MOTE IJHOTEL. 0 PUMPER TRUCKIYARDICHEM-TOILETS <br /> a TATTOOIBODY PEIRCING C] POOLlSPA ❑ LAND USE APPLICA770N SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM Q OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses in tl'e space above. Select the typa(s) of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to 209 464-4)138 or mail to the <br /> address,indica,ted above. { <br /> 2. EHD will notify the applicant If any EHD files exist. At1 appointment for review will be confirmed <br /> approximately live business days but no'later than ten (10) days after receipt of application. The fifes <br /> will be held fora 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. Anew <br /> application may be Submitted when the file Is available. 9 EHD-staff at the expense <br /> 4, Any file not returned in the same condition as released waill be may require a$78.00 deposit prior <br /> of the applicant. Future file reviews by the.same app Y R <br /> 5, *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3'30 pm will be processed the next:business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EN 00 14 0IM-WO6 - <br /> I. <br />