Laserfiche WebLink
11/17/2003 16:16 4640138 ENVIRONMENTAL HEALTH PAGE 01 <br /> nrc�MEQ SAN JOA UIN COUNTY cnv t_wwu <br /> � muN <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> N O U 1 7 2 304 E Weber Ave 3'd Floor Stockton,CA 95205 <br /> )468-3420 Fax:(209)464-0138 Web:www.co.san-joaquin.ca.us/ehd <br /> ENVIRONMENT HEALTH <br /> LSPUBLIC RECORDS RELEASE APPLICA'T'ION <br /> �F.�. E�CE S <br /> APPLICANT: Didrik Johnck BUSINESSIAGENCY: Geologica <br /> ADDaEss: 594 Howard Street, Suite 400 <br /> HONE: 415-297-7903 FACSIMILE: 772-402-4834 <br /> TENTATIVE'APPOINTMENT DATE: Time. <br /> (Please allow 10 business days from date of application submittal) <br /> f-+ CHECK BOX TO EXPEDITE REQUEST- 00 F -REQUEST PROCESSED IN 3 BUSINESS DAYS 11/17/03 <br /> 0SIGNATURE OF APPLICANT DATE <br /> Department Use Only <br /> FILE ADDRESS UNIT <br /> 800 Mellow, ❑ unit I <br /> i. <br /> ,. Moffat B ❑ Unit 2 <br /> oat Blvd 5� <br /> Uncft it <br /> 9. <br /> 1„ <br /> 9. oat Blvd., Man a <br /> t. sweat nit 4 <br /> s. Unit 5 <br /> CKY <br /> to. 9emt <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> "UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT O SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) O FOOD FACILITY 0 SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> O HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> O TIERED PERMrMD FACILITY 0 MOTELIHOTEL 13 PUMPER TRUCK/YARDICHEM TOIL <br /> C3 TATTOOIBODY PIERCING D ClPOOLISPA LAND USE APPLICATION SITES <br /> O MEDICAL WASTE FACILITY O OTHER(PLEASE SPECIFY) <br /> 1, List up to tan 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 /> addreS51 I above. <br /> 2. EHD•will notify the applicant if any EHD fifes 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 beheld 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 END 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 /> 6. Applications received after 3:00 pm will be processad the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE . FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> N.rme� • <br />