Laserfiche WebLink
05/08/2003 13:50 FAX _. _ 002 <br /> `..._nw�j RECLVfiD <br /> !. ;iSAN JO�UiN COUNTYPUBLIC HEALTH 5F /ICES <br /> ENVIRONMENTAL <br /> NUEL'i'Hl� FLODIVISION <br /> OR� <br /> 304 EAST wE ER AVE: <br /> W1 AY 0 8LSU� STOCKTON CA 96202 �• <br /> (209)4683420 <br /> `-'PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT 1t k11 L1 _j a,r>NI BUSINESWAGENCY�� <br /> fit <br /> ADDRESS <br /> C116 FACSIMILE b3� • .— <br /> PHONE <br /> TIME _�`"! /1?1 <br /> TENTATIVE*APPOINTMENT DATEVI�1� <br /> (Please give 7 to 10 business days from date of application sabinittaf) <br /> i <br /> REQUEST-$78,00 FEE-RE OCESSED IN 3 BUSINESS I)AY5 3 <br /> t �7 <br /> CHECK BOX 70 EXPEDITE Q <br /> Q, OATS <br /> SIGNATURE OF APPLICANT <br /> THiSSIDE E�D STAFF USE ONLY <br /> FILE ADDRESS pk0(i1?,AM..,_LEMENTS SEARCH <br /> G S ` <br /> Z <br /> Qir � ow nr • . <br /> • Z&01 h�Q.l1 LL1,v►c t.ol�i (A <br /> � <br /> ENVIRONMENTAL HEALTH DIVISION FILLS <br /> C3 HOUSING ABATEMENT 1] :30LIll WASTE FACILITY <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ FOOD FACILITY 13 :SOLA)WASTE VEHICLE <br /> ❑�,/OTHER CLEANUP SITE(NON-LOP) i7 DAIRY <br /> fG UNDERGROUND TANK(MONITORINwREMOVAL) O DOG KEN RNEL l7 PKG TREATMENT PLANT <br /> O HAZARDOUS WASTE GENERATOR CHICKEN <br /> RANCH 13 PUM3ER TRUCKIYARD/CHEM TOILETS <br /> ❑ TIERED PERMITTED FACILITY [3 M❑ POOUSPA TEL M IIID USE APPUCAT40H SITES <br /> ❑ TATTOOlBODY PEiRCING G pUB�WATER SYSTEM 17 OTHER(PLPASE SPECIFY ABOVE) <br /> O MEDICAL WASTE FACILITY <br /> �, List up to ten addresses in the space above. Select the type(s)of tiles from the,list above by checking <br /> the appropriate box(es). At least one file type MUST be selsct�:d. 209y ;or mafl�o tt ei <br /> address Indicated eve. ointment for rl:view Will be Confirmed <br /> EHD will notify the applicant if any EHD flies exist. An app receiptays after <br /> approximately five business daye busirlebut no!stday5 for revieer than ten w Appolnl elts should pbe schedule <br /> will <br /> will be field for a maximum of rn <br /> accordingly. <br /> -03. A fila that is actively being worked on by EHD staff may not be imrrlediat(:ly available for review. A naw <br /> application may be submitted when the file is available. at the <br /> 4. Any file not returned In the same condition as <br /> released cant tris ll be r re•u�ire�at�78 OOHdepaaf t prior to review. <br /> of the applicant. Future file reviews by the same app• Y <br /> 6. *I•ENTATNE appointment dates must be confirmed with EHD staff. • ,' „_ <br /> 6. Applications received after 3:00 pm will ba processed the next bu�:iness da <br /> I CONFIRMED APPOINTMENT DATE TIME _•_ --- <br /> DATE CONFIRMED X <br /> PHONE FAINITIALS <br /> REVIEWED• YES NO REVIEW DATE:,.---T„ --- <br /> SK Q0 14 0zFz4M TOTAL P.02 <br />