Laserfiche WebLink
ice• ... . c,o lv.Vu r-'ii 1~:.K.1. 0001 <br /> iG—Gtf 177 t,l•o�rt•1 rt��l•1 to <br /> 1.4153E321 RSG P.n ON <br /> ' OATS RPCEJVED nuus�ct <br /> SAN .&QUIhf OOUNTYPUBLIC HFIALTH : VICES AMD roc _ <br /> ` ENVIRONMENTAL HEALTH DIVISION. <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> � ✓ S10CKTON CA 95202 • <br /> (209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATIONFr 9 =9 <br /> `� <br /> APPLICANT {^LAV L- T-21 1,Sv aUSINES$1AGENCY X11 Rip tlr�p J�7►.�_/ 1:�dSo LuTL�*-�S 1 '�J� <br /> ADIDRESS T3 -S—M I e-A g`in1 I <br /> PHONE 81,:b QFACSMAILE �) M— <br /> TEM'AME"APPOINT /Z-30— <br /> APPOINTMENT GATE /Z~30—J / TIME <br /> (Please AIve'T to 10 business days from&te of appbcaSort submilLan <br /> CHECK BOX TO EXPEDITE REQUEST•*78.09r REQUEST PROCESSED N 3 B=NrzrS DAYS <br /> SIGNATURE OF APPLICANT DATE 1Z-2 <br /> FILE At) RE S <br /> 3 u1-E VrLG., — 41s <br /> u e 7b <br /> 1 Z <br /> LA 0 <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> XUNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ H04JSING ARATFT1FNT Cl SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-I-OP) ❑ FOOD FACILITY 0 SOLID WASTE VEHICLE <br /> tiNDERGROUND TANK(MONITORWGAZEUOVAL) O DOG KENNEL Q DAIRY <br /> HAZARDOUS WASTE GENERATOR Q GHIGKEN RANCH D PKG TREATMENT PLANT <br /> Q TIERED PERAirTTEI]FACILITY ❑ MOTELIHOTEL a PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑ TATTOOJBODY FEIRGING ❑ P001.115PA ❑ LAN13 USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 7. List up to ten addresses in the space above. Select the type(s) of filets from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to M91 464-0138 dr mail to the <br /> :�ddre s iryjlcated above. <br /> 2. EHD will notify the applicant if any EHD files exist An appointment for review will be confirmed <br /> approximately fire 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 beiltg worked on by EHD staff may not be immediately available for review. A new <br /> applirnatinn may be submitted when the file Is available. <br /> 4. Any file not returned In the same wnhition as released wfll be reorganized by EHD staff at the expense <br /> of the applicant Future file reviews by the Same applicant may rquire a$78.00 deposit prior to review. <br /> S. 'TENTATIVE appointment date-- must bL-confirmed with EHD staff. <br /> 6. Applications received after 3:Q0 pm will be processed the next business defy. <br /> ;za <br /> H,7�1�I C-^':�•�A� .iyy �,N,. 1S M ._"•S-:Ir i `i� 1',Z._ ;C)�+trti.c.�s. 'n. ♦ .,ri `�'S+E,i}�;'-1,�:�xi. _ � .' <br /> .flAJ ,''3:;<ir <. <br /> ,7 <br /> C�u '1ti /\ 1 a l l9 1 TOTAL P-02 <br />