Laserfiche WebLink
4-12-02; 2:09AM; IT/EMC0N ;916 928 3341 u 1/ 1 <br /> FF <br /> 040 4640136 ENVIRONMENTAL L PAGE 81 <br /> LI.L_Jl iUYu W. <br /> NtG ¢u <br /> AN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> " 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> 02 APR I I PI-1 3. 23 (209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> pp � <br /> APPLICANT ahl-I&4Yl.Jt� 1�clC#II BUSINESSIAGENCY <br /> ADDRESS 3Z - '• .�.0 �- `'� <br /> PHONE 4(_--.6- 56 5- 4 0 FACSIMILE <br /> ��/�, ��� 9' <br /> TENTATIVE`APPOINTMENT DATE TIME �wn d kp:"c onsubmittal) <br /> (Please give T o 1 fap�+❑ CHECK BOX TO EXPEDfIE REQUEST-589.00 FGEE•`1R(EOUEST PROCE3 8 INES3 DAYS v <br /> � SATE �---- <br /> SIGNATURE OF APPLICANTTHIS SIDE HD STAFF USE <br /> Y <br /> FILE ADDRESS <br /> PROGRAM ELEMENTS SEARCH O <br /> N <br /> ;f � <br /> s. <br /> 2 <br /> N <br /> Fh %'J 2 W <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> ❑ HOUSING ABATEMEM <br /> C3 SOLID WASTE FACILITY <br /> ® UNDERGROUND TANK'NST)CLEANUP SITE(LOP) 0 FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> IP OTHER CLEANUP SITE(NON-LOP) ❑ p00 KENNEL 13 DAIRY <br /> a UNDERGROUND TANK(MONITORINGIREMOVAL) In CHICKEN RAMC ElPKG TREATMENT PLANT <br /> a HAZARDOUS WASTE GENERATOR ❑ moTEuHOTEL ❑ PUMPERE APPLICATION SIT TOILETS <br /> ❑ TIERED PERMITTED FACILITY ❑ POOUSPA ❑ LAND USE APPLICATION SITES <br /> ❑ TATTOOIBODY PEIRCING El PUBLIC WATER SYSTEM [3 OTHER(PLEASE SPECIFY ABOVE <br /> O MEDICAL WASTE FACILITY <br /> List up to ten addresses In the space above. Select the types)of files from the list above by checking 38 or mail to the <br /> the appropriate box(eS). At least one file type MUST be selected. Fax to 219 64 01 <br /> address indicated above. EHD files exist An appointmentfor review will be confirmed <br /> 2. EHD will notify the applicant if any <br /> approximately five business days but no later than c of vle�Yd Appointments receipt <br /> shouldpbe scheduled ion. The files <br /> will be held for a maximum of five business day <br /> accordingly. HD Staff may not be immediately available for review. A new. <br /> 3- A fife that is ctive)y being worked on by l EHD staff at the expense <br /> application maybe supmitted when the file is available.will deposit prior to review. <br /> 4. Any file not returned in the same condition as released ant be reorganized by <br /> of the applicant. Future file reviews by the same applicant may require a 589.10 dap <br /> 6. "TENTATIVE appointment dates must l confirmed <br /> P oC9uedthe n D t business day. <br /> 6 Applications recetaff- <br /> ived after 3:00.p <br /> 71ME <br /> CONFIRMED APPOINTMENT DATE INITIALS 'r <br /> DATE CONFIRMED <br /> PHONE FAX <br /> REVIEWED _ <br /> YES NO REVIEW DATE <br />