Laserfiche WebLink
Oct 25 02 04: 113P Mice =el Harrison (510) q4G-9501 P. 1 <br /> 10/25/2002 16:02 46401 ENVIRONMENTAL HEALT. PAGE 01 <br /> - EI N)x,04 NUMOEA <br /> SAN JOAQUIN COUNTYPUELIC HEALTH SERVICES <br /> 0q!5 <br /> ENVIRONMENTAL HEALTH DIVISION 10Y5 <br /> v 1304 EAST WEBER AVENUE,THIRD FLOOR ' <br /> STOCKTON CA 95202 <br /> (209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> 1. <br /> APPLICANT J LA-- • 8USINESSIAGENCY_LN✓r/`CliSSc�S <br /> ADDREss o/Zodo �ow� Q/ S4.` Ge�r.,.�r{�o�Cr¢ 9f 5 <br /> PI/ONE(S/0) 3Y6- 9S4?12 FACSlAe11E TIO-) <br /> TENTATIVE"APPOINTMENT DATE /,5/L L z TIME <br /> (Please®Ivo 7 to 1t1 bustnaSA da ram dale ap tion submittal) <br /> CHECK 13OX TO EXPEDITE REQUE 0 SS USINESS DAYS <br /> SIGNATURE OF APPLICANT DATE Z dz` <br /> FI&E ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> ✓� oo G'Ea Lo/J i C- et <br /> A/: l .ti0 <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> ❑ UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT 0 SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) D FOOD FACIUTY ❑ SOUo WASTE VEHICLE. . <br /> 0 UNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL ❑ DAIRY <br /> O HAZARDOUS WASTE GENERATOR O CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY 0 MOTELIHOTEL O PUMPER TRUCK/YARDICHEM TOILETS <br /> O TATfOOISODY PEIRCING O POOLISPA Cl LAND USE APPLICATION SITES <br /> O MEDICAL WASTE FACILITY 0 PUBLIC WATER SYSTEM IJ OTHER(PLEASE SPECIFY ABOVE) <br /> 7, List up io ton addresses in the space above. Select the types)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the <br /> address Indicated above. <br /> z EHD will notify the applicant if any EHD riles exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ton (10)days after recolpt of application. The riles <br /> will be held for a maximum of five'buSlness days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that Is actively bntng worked on by EHD staff may not be immediately available for review. A new <br /> application may be submitted when the filo is available. <br /> 4. Any fife not returned in the same condition as released will be reorganized by EHD staff at the oXpanse <br /> of the applicant. Future file reviews by the samg applicant may require a$89.00 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 /> CONFIRMED APPOINTMENT DATE, TIME - <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE _ <br /> I <br /> I <br /> i <br /> i <br />