Laserfiche WebLink
DATE RECEIVED - <br /> SAN JC�UIN C4UNTYPUBLIC HEALTH VICES <br /> ENVIRONMENTAL HEALTH DIVISIOIT - <br /> 304 EAST STOCKTONEBERAVENUE, <br /> I O FLOOR [)EC 9 2003 <br /> CA(209)468-3420 <br /> ,lit, r iii fiG-1 <br /> PUBLIC RECORDS RELEASE.APPLICATION ER�,n,„�;�� , ,._ _ <br /> APPLICANT t�]t,l Alms,.,.. BUStNES5JAGt2NCY I�hrls� G?c�' nc- -_.— <br /> ADDREss_ �r t„bhUL- (Ays°.,t1Ue SU i t e 8 j1 <br /> PHONE QJU`� �TLl ` k 01 FACSIMILE IN <br /> TENTATIVE*APPOINTMENT DATE TIME <br /> (Please give T to 10 business drys frau date of application submitbd) s <br /> 0 CHECK 80X TO EXPEDITE REQUEST-$7>5.00 FEE-REQUEST PROCESSED IN off BUSINESS DAYS n <br /> DATE I - CA <br /> SIGNATURE.OF APPLICANT &=a �--- o <br /> MILE ADDRESS � <br /> qbTn west <br /> Ed . <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> A UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOUD WASTE FACILITY <br /> $1 OTHER CLEANUP SITE(NON-LOP) E3 FOOD FACILITY C3 SOLID WASTE VEN1= <br /> JI UNDERGROUND TANK(MONITOMNG/REMOVAL) CU DOG KENNEL 0 DAIRY <br /> 1M HAZAROOUS WASTE GENERATOR ❑ CHICKEN RANCH' D PKG TREATMENT PLANT <br /> FACtLIiY D MOTELIMOTEL a PUMPERIRUCKlYARA/CHEMTiALETS <br /> ❑ TIERED[>QtMtTYED <br /> ❑ TATTOOfE1ODY PEIRFAC CING <br /> 0 POOLISPA ' C7 LAND USE APPLICATION SITES <br /> Q MEDICAL WASTE FACILITY PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABON 11 <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by ah Ecking <br /> the appropriate boxes). At least one file type MUST be selected. FaX to (209) 464-0138 Dr ma12� j <br /> address lLidic;ktqA 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 niter than tea(1 A)clays after receipt of application- Th a files <br /> will be held'for a maximum of five business days for review. Appointments should be scheduler <br /> accordingly. <br /> 3. A file that is actively being.worked on by END.staff may not be Immediately available for review. A now <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 I?HD staff at the expense: <br /> of the applicant. Future file reviews by the same applicant may require a$78.04 deposit prior to revie*- <br /> S, '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 /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INTTWLS <br /> REVIEWED YES NO REVIEW DATE - - - - . <br /> U MMSM <br />