Laserfiche WebLink
END LOG NUMBER <br /> PAYE Ar;COVED /SAN JOAQUIN COUNT'YPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> n (209)48820 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPI.It~ANT <br /> n tV���E INESSIAGENCY /� <br /> �- -ti BUSC A <br /> ADDRESS ,�� Q � . i � ~• <br /> FRONF goo `]1 Co�4 ._FACSIMILE �►--� <br /> ' L-, <br /> �sra�A1r • �,e� <br /> TEVTATIVE"APPOINTMENT DATE 1� \` TIME <br /> (pleasa give 7 to 10 busineao dAys from date of application submittal) <br /> 15CNECK BOX TO EXPEDffF REQUES - FEE--REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> C U.n <br /> UdaEss <br /> ti k u �t -951 <br /> — <br /> C-1 T o4 <br /> ILLIk M. <br /> t e>t L1 <br /> � <br /> t�nU►iZt� P <br /> tom , C:.A�v C,�w�P i� us.?T -rPtt <br /> La <br /> In ENVIRONMENTAL HEALTH DIVISION FILES <br /> I 113SOLID WASTE FACIIATY <br /> ❑ NDERGRGUN TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOUD WASTE VEHICLE <br /> Pd OTHFR CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY <br /> 13 DOG KENNEL E3 DAIRY <br /> Q UNDERGROUND TAMC(MONiTORINGfF2EMOVAL) ❑ CHICKEN RANCH ❑ PKG TREATMENT PLAW <br /> ❑ KAZARDOLS WASTE GENERATOR p MOTELIHOTEL ❑ PUMPER TRUCKtYARDlCHEM TOILETS <br /> ❑ TIERED PERMITTED rAGILITY G) p0011SPA ❑ LAND USE APPLICATION SITES <br /> ❑ TATTOOfS IDY PEIRCING ❑ PUBLIC WATER SYSTEM (S) <br /> OTHER(PLEASE SPECIFY ABOVE) <br /> ❑ MEDICAL WASTE FACILITY <br /> s)of files from the list above by checking <br /> 1• List up to ten addresses in the space above. Select the type <br /> thn appropriate box(es). At least one filo type MUST be selected. Fax to(.2091 464.12138 or mli a the <br /> address indicates) above- <br /> firmed <br /> Z. EVID will notify the applicant if any EHD files exist. An appointment for review will be con <br /> approximately five business days but no later than tett(10)days after receipt of application. The files <br /> wi I be held for a maximum of five business days for review. Appointments should be scheduled <br /> ac cording ly. <br /> 3. A Nile that is actively being worked on by Eib staff may not be immediately available for review. new <br /> appiication may be submitted when the file is available. <br /> 4, Ar y file 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 requite a$78.00 deposit prior to review. <br /> 5. *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 /> E <br /> ED APPOINTMENT'DATE TIME <br /> FIRMED PHONE FAX INITIALS YES NO REVIEW DATE <br /> EH 00 14 017M44 <br /> T12 -4n)t;r-I SS38JX3 NNI A CII�OH 008TES860Z 9t':10 0002/ZOIZt <br />