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SITE INFORMATION AND CORRESPONDENCE_CASE 1
EnvironmentalHealth
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SITE INFORMATION AND CORRESPONDENCE_CASE 1
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Last modified
2/10/2020 4:59:51 PM
Creation date
2/10/2020 4:06:09 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
FileName_PostFix
CASE 1
RECORD_ID
PR0545336
PE
3528
FACILITY_ID
FA0003776
FACILITY_NAME
KWIK SERV LODI BW 113*
STREET_NUMBER
420
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
06202042
CURRENT_STATUS
02
SITE_LOCATION
420 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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07/17/20133 14' 7 200460%..43 FIFTH FLOOR v PAGE 92 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DIVISION <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT PHONE NO <br /> ADDRESSa I%Tu-n'7 PHoIVE r70 _ <br /> AG E NC 4 NAKE <br /> ADDRESS 45150ndLakes 0rive d AJ5u :2Z ' <br /> �MIXTUN.CAUFORNIAy' <br /> FULL ,DDRPESS„ B YST LESS NAME RIZCGRAM OR <br /> FAC,'IT,ITY PE OF FTLE <br /> 'Sf.20 pi Lo - /o-;5 are, f e1�e+r 711�a <br /> k'A'•k7E'Yf** CX`k+k'k'k'1 'k-t IC Yf*"f*#'1!#X klc 7ttk ih 7Y 7C'7C lkf#'Cii'klb***iri•-kYC`k 7rY:b 7r 71-Y7k'4+t'k i'*sk YC* <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> SERVICESIENVIRONMENTAL HEALTH DIVISJON (EHD) POLICY x+94-007, ORDINANCE CODE OF <br /> SAN JOAQUIN COUNTY, EMO FEE AND SERVICE CHARGE RESOLUTIONS, STATE WATr:R CODE, <br /> GOVERNMENT CODE AND THE EVIIDENCE CODE. <br /> 1. A MAXIMUM OF TEIV SOI PREMISE ADDRESSES PER REOUEST <br /> 2. PUBLIC FILES/RECORDS REVIEW IS BY APPOINTMENT ONLY. APPOINTMENTS ARE PROCESS- <br /> ED BY CALLING 12081468-3420. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY <br /> THRU FRIDAY EXCLUDING HOLIDAYS, 8.00 AJC) TO 12:00 NOON AND 1:00 TO 4.30 PM. <br /> 3. A PUBLIC PILESMECORDS RELEASE APPLICATION (PRRAI IS REQUIRED. <br /> 4. PUBLIC FILESIRECORDS NOT RETURNED IN THE SAME CONDITION AS RECEIVED WILL 8E, <br /> CORRECTED BY THE EHO STAFF AT THE EXPENSE OF THE APPLICANT_ THIS ADDITIONAL <br /> SERVICE WILL HE BILLED TO THE APPLICANT FOR PAYMENT. (SEE EllD POLJCY 94- 007) <br /> 5. ORIGINAL PUBLIC FIDS/RECORDS SHALL NOT B/RF-:IAIA ED FROM THE EHD PREMISES. <br /> ---------+----------r+r r�� r.��� rrt��jf►s�-t------------------ <br /> SIGNATURE <br /> -------------+--SIGNATURE OF APPLICANT DATC / J r <br /> SIGNATURE OF RELEASING OFFICIAL. DATE <br /> EH 00 14 (REV 9196) <br /> Z00/zoo in SaXVI 'IIFllb-1MS d0 }I VE OT81 6Z6 60Z T XVI TStCT 11112 COOZ/LT/LO <br />
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