Laserfiche WebLink
,Nov 17 04 05: 11p Hanr ar Inc <br /> 530 2 1490 p, l <br /> 1 417k,�_ <br /> iV \ SAN JOAQUIN COUNTY io LOG NUMBER <br /> N 0 U 1 7 2004 ENVJRONMENTAL REALTH]DEPARTMENT <br /> 304 E Weber Ave 3rd Floor Stockton,CA 95205 <br /> FNVIRONP MI'_'MQ� 8-3420 FRV(209)464-0138 Web:www.co_san-joaquin_ca_US/ehd Z ( 3 <br /> PFRMIT/SER 11 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 1-t- F C f � BUSINESSfAGENCY: > i uuue�L <br /> ADDRESS: Q - <* C21 T `Z2e> , Cftl Lm C6� <br /> PHONE: _FACSi1�lLE: <br /> TENTATIVE*APPoWME 1T OATS: <br /> (Please allow 1Q business days from date of■ppficapon 3ubmfttai) <br /> EJ CHECK BOX TO EXPEDM REOuEST-$9 EE _ST P SFD i ESS DAYS Jl <br /> SIGNATURE OF APPUCANT DATE <br /> Deparvrem Use Only <br /> UNIT <br /> FILE Al)DR1=S5 � <br /> ❑ Unit 1 <br /> z SROM Q <br /> ❑ u ! <br /> _ a <br /> ty <br /> a. Unit 3 <br /> 6. 3YRe1 <br /> Unit 4 <br /> a <br /> ° suO.t <br /> _r, Cl Unit 5 <br /> ). 6Yod I <br /> U <br /> 10. Sleet � <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> OiQjjDERCaROUND TANK 01ST)CLEANUP 5�(L� d FOOD FA ABATEMENT ❑ SOM WASTE VEHICFACIL7 <br /> Hab-�rRouNND <br /> SRE(NOR-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE YEHaCI E TANK JUONITOWNGIREMOYAL) QDOGKENHELO DAIRY <br /> WASTE GENERATOR Q CHICKEN RANCH d PKG TREATMENT PLlJif <br /> [] TIERED PEWAITTEU GENER ❑ MOTELIHOTEL L3 PUINPER TRUCMARDrCHEM TOILETS <br /> DTATT00�900Y PIERCING 13CI LAND AND u5E APPLICATION SITES <br /> ❑ ME'DICAL WASTE FACR TY ❑ OTHER(PLEASE SPECIFY} <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above�y chocking <br /> the appropriate bOX(es). At least one Tile type MUST be selected. Fax to(209)464-0138 or mats to the <br /> *dd'ross lndbcated above. <br /> 2. EHD v�Ul notify the applicant if any EHD files exist An appointment for ce pt will be colon. The <br /> approximately five business days but no later than ten(10)day-- <br /> app <br /> ays after receipt of application. The files <br /> will be hold for a maximum of five business days for review. Appolritments should be scheduled j <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD stiff may not be immediately avallable for review. Anew <br /> application may be submitted when the file is available. <br /> 4. Any file not returned In the Sarnia condition as released will be reorganized by EHD staff at the expense . <br /> of the app'1cant. Future file reYlews by the same applicant may require a$93.00 deposit prior to review. <br /> 5. 6-TEHTA' U1_:a;op©lntment dates must Le ccnfirmed with EHD staff. <br /> 6. App!icatiu'ns received after 3:00 pm will be processed the next business day, <br /> � TIEki� <br /> NF1f 1�11�D-!4TMeur:DATE -h;.� _ <br /> .PHONE FAX <br /> .PATE CQIJFIR?4ED. <br /> REVIEWED t YES NO REVIEW DATE. <br /> fNi7 M-0I-0ai <br /> I0 39Vd Hl-1VV3H -jV_LN3WAi0dIltf43 BE10179D 0L:9I 1700L/LT/IT <br />