Laserfiche WebLink
10/17/2003 15:14 9253715915 GEOCON - EAST BAY PAGE 01/6 <br /> 10/14/2803 09:49 .4641: 18 ENVIRONMENTAL, �4LTH PAGE 01 <br /> DATE f�EcsIVF.D SAN JOAQUIN COUNTY <br /> HEALTH ry p D T <br /> ENVIRONMENTAL L�iR��+�RMNI' - <br /> C T 7 ZO 304 E Weber Ave P Moor Stockton,CA 95205 <br /> 309)468-3420 Fax: (209) 4¢40138 Web:www.co.San joaquuj.cs ,, /r_hd . <br /> ;=i;�.i�T!�F P�UBLSC RECORDS RELEASE APPLICATION <br /> APPLICANT.- BUSINESS"RNCY:tv- c�OCO CSO A �r9C. <br /> ADt)R"S: 2A t <br /> �.i z e <br /> PHONE: Z FAWIMILE-1 Z r <br /> TENTATIVE''APPOINTMENT DA'r%- <br /> OT�: taass aw 10 a afnese ays IMM data nt eatl4n submittal) <br /> itI -- <br /> .Wf a�G r <br /> CHECK BOX TO EXPE-Dr E RCQLIES as FEE UEST P E MUSINESS DAYS �a <br /> SIGNATURE CF APPLICAN DATE <br /> oepadmem[lea 0* <br /> UNIT <br /> FILE ADDR MS . <br /> 3C ❑ Unit i <br /> }Z' <br /> Orem <br /> Unit 2 <br /> rvL <br /> It <br /> a. d <br /> Urft <br /> 3 <br /> -street n <br /> 3Iteel51 G <br /> Z <br /> c <br /> ENVIRONMENTAL HEALTH Dt?PARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE ILOPI C1 HOUSING ABATEMENT 13 SOLID wA5TE FACILITY <br /> M OTHER CLWkNUP 8ITA(NON-LOP) D FOOD FACILITY ❑ SOLID LPIA>ST1:IIIEHLCL! <br /> D UNDERGROUND TANK IMONrrORINWREMOvAL) [3 OOG KENNEL . 0 DAIRY <br /> in HAZARDOUS WAS'CE alENERATOR 17 CHICKEN PANCH In PKG TREATMENT PLANT <br /> ❑ TIERED PHItMITTFD FACILITY 0 MOTFLIHOTEL 0 PUMPER TIRUCKlYARDICtIEM TOILETS <br /> CI TATTOOMODY PIERCING ❑ POOUSPA 0 LAND U!E APPLICATION 30125 <br /> 0 MEDICAL WASTS FACU rrY II OTH R(PLEASE SPECIFY) <br /> type(s)of files from the list abOYO by checking <br /> 1. Gist Lap to ten addresses in the spare above. Select the <br /> the appropriate box(es). At least one file type MUST be selected. Fax to (2081�t64-p4311 nr mail to the <br /> address i d above. <br /> 2. EHD will notify the applicant If any EHD files exist. An appolrltrnent for review will be LAnflrmed <br /> approximately five busineas days but no later than tars(10)days after receipt of appiicatlen. The tiles <br /> will be held for a maximum of five business days for review. Appointments bhould be scheduled <br /> accordingly. <br /> 3.. A file th-at is actively being worked on by EHD staff May not be immediately available for review. A nem <br /> application may bs submitted when the file is available. <br /> 4. Any File not returned in the same conrlltlon as released will be reorganized by 1 HO staff at the cxpetss6 <br /> of the applicant. Future file reviews by the same appiiCant mey require a$93.00 4eposlt prior to reviev <br /> a ointment <br /> dates must be confirmed With EHD staff. <br /> TEIVTAT"IVE p <br /> S. P <br /> 6., Applications received after 3.00 pm will be praaAsead the next business day. <br /> CON FI RME0'APP0iNTM1=NT DATE TIME <br /> DATE CONFIRMEDPHONE FAx ' INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> eno 4a•ozaaa <br /> ererzaas <br />