Laserfiche WebLink
05/20/2004 12:53 3037«8889 TECHLAW INC PAGE 02/0 <br /> DATE RECEIVED EHD LOG NUIA <br /> ( SAN JOAQUIN COUNTY <br /> I �) ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave and Floor Stockton,CA 95205 <br /> MAY 2 1 CUn 468-3420 Fax: (209)464-0138 Web: www.co.san-joaquin.ca.us/ehd <br /> ENVIRONME(J HEAL---lH PUBLIC RECORDS RELEASE APPLICATION <br /> i' i r✓ _ <br /> APPLICANT:% BUSINESSIAGENCY: I [' � V V <br /> �{ C— 2 <br /> ADDRESS:__ID S2\\U UI L�I�QYI �ID�C2 i�i1 � I?-O \ O�jPYI Dp SSD qD I <br /> PHONE:12-O 3)41 lQ=�22 -501 FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE: Time: U' V l� 2,M <br /> QI}evn2t�c - <br /> (Please allow 10 business da s from data of application submittal) ' I c.nnt �ctS 21 (7 <br /> 02rCHECK BOX TO EXPEDITE REQUEST.$93.00 FEE—REQUEST PROCESSED IN 3 BUSINESS DAYS Army >zn rtn e.r-0 <br /> SIGNATURE OF APPLICANT ( Slrgc,-14 DATE 911 0 51r)t4 <br /> � .r � <br /> Depanment Use Only <br /> FILE ADDRESS UNIT <br /> ,. s,reet S Uc Ir cx 3 �- ❑ Unit 1 <br /> 2, stmt <br /> &av Unit 2 <br /> 4. Street (, <br /> 5. street <br /> Unit 3 <br /> a. street C <br /> CA; <br /> 7. Street C. <br /> nit 4 <br /> e. sweet c <br /> 9. street C' <br /> ❑ Unit 5 <br /> to. street � <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT 'X SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY D SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITOR]NGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARD/CHEM TOILETS <br /> ❑ TATTOO/BODY PIERCING ❑ POOUSPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <br /> 1. List up to ten addresses In the space above. Select the type(s) of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(2091454-0138 or mail to the <br /> address indicated above. <br /> 2. END will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately five 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 being worked on by EHD staff may not be Immediately available for review. A new <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 EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> S. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> FP 1 <br /> G. Applications received after 3:00 pm will be processed the next busines--fday: ? '` <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EHD 45.02-om <br /> tJaf200J <br />