Laserfiche WebLink
.,U t, iltFi <br /> SAS! X `.UIN C+OUNTYPUBLIC HEALTH S VICES <br /> ti ENVIRONMENTAL HEALTH DIVISION � � <br /> 304 EAST WEBER AVENUE,THIRD FLOOR - <br /> STOCKTON CA 85202 <br /> (209) 468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APP LI N _BUSINESSIAGENCY ' <br /> A RESS D � S�/LL[J !'[DLY��� u`•'�c'�L' r J� S <br /> HONE ,902 :11d'7`raa FACSIMILE �?D}��.� � ��/ M=I - <br /> TENTATIVE* <br /> APPOINTMENT DATE s 5-A TIME j •-3-a-Am'' ," "' I ' <br /> �•r <br /> (Plcase UNe 7 to 1 business days from date of applicatlorn submittal) r','t' I S <br /> TS _3,. 1h $ 1$ Pel l' � <br /> .CHECK 13OX TO EXPEDITE:REQU -578.00 FEE—REQ ST p IXESSEp IN 3 BUSINESS DAYS �` Q�Y��" yesle <br /> SIGNATURE OF APPLICANT DATE <br /> FILE ADDRESS <br /> - <br /> N F r— <br /> lAl <br /> �i ftnI E t r r E► /loo/ / p„� IG/ ?9S6 0/ 39 �3rol, Z 23Go <br /> d� 4- O <br /> +� r dao <br /> 161!y.2. �j,5 .2359 4?,3% ?3L0 .236 .9360 303 03 , 230 2.3� <br /> \/ <br /> / Xk /64y �23 /600 <br /> ENVIRONMENTAL.HEALTH DIVISION FILES <br /> CONTIEW % <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) M HOUSING ABATEMENT 0 SOLID WASTE FACILITY <br /> OTHER CLEANUP SITS(NON-LOP) 0 FOOD FACILITY ❑ SOLIO WASTE VEHJGLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KIFENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR M CHICKEN RANCH ❑ PKG TREATMGNTPLANT Il�V 25 2ur� <br /> �� <br /> 0 TIERED PERMITTED FACILITY ❑ MOTELlHOTEL 0 PUMPER TRUCKJYARDJCHEM T 1 TS <br /> ❑ TATTOOMODY FORCING M POOLJSPA C LAND USE APPLICATION SrrES <br /> r:I MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM D OTHER(PLEASE SPECIFY ABOVE) <br /> 1. t.lst 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)464-0138 or mall to the <br /> addrgss 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 five business bays 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 avaifable for review. A new <br /> application may be submitted when the filo is availabie. <br /> 4. Any fila 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 $75.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received atter 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CCNFIRMED PHONE FAX INMALS <br /> REVIEWED YES N0 REVIEW DATE <br /> FH as E� atroyroa <br />