Laserfiche WebLink
��07/2004 WED 14;30 FAg4 R02/002 <br /> c,a.r+j r r cau•. L4;V0 4a ao r-NV 1KUNM-1v I HL�I M VAUt V1 <br /> DATE RECIV I Dt1U LW R.,Mu.`1. <br /> (p vft_' i,�, �,r,1. SAN JOAQM.N COUNTY <br /> W L�('0 <br /> ��— j_;J ENMONN xnAL WALTU DEPARTMENT <br /> 304E Weber Ave 3'd Floor Stockton,CA 95205 <br /> JAN 0 7 2.001 (209)468-3420 Fax:(209)464-0138 web:www.coxaa jvaquin.catrslchd <br /> ENVIE CJ,�i�iE sa I �nLi PUBLIC RECORDS RELEASE APPLICATION <br /> PERP,! ; �/ �, � ®/J •�y <br /> APPWCANT:7.1C�i1.7 '//liY! f.(1 � BuS1NF 31AGFJICY:�y� .S OC_ <br /> ADDRESS: f J " ��' a4eE&F('60 p. CA <br /> PHONE: <br /> TENTATIVE*APPOINTME 17 DATE: � �3 p Tame: <br /> (Please allow 10 buSlnass days*Ml date of appllCat3an aubmitlai} 0 GJ/a- otj;v <br /> q.pN 7`btS&P tY <br /> 1 I� <br /> CHECK BOX TO EXPEDrTE REQUEST•S93.00 FEE-rtEQlIfiST PROCESSED IN 3 BUSINESS PAYS v <br /> z _17 � <br /> SIGNATURE OF APPLICANTDATE <br /> Department Use Only <br /> F11-t ADDRESS UNIT <br /> saw+ OSiq Unit 1 <br /> 005 � <br /> a hl� UnIt 2 <br /> ,. Street 03 av -PRr <br /> s, sc 1 d 540 vA rn 13Unit 3 <br /> e. swat e7+a Af R, A• <br /> s / r t1-1 LE tc115 Q 0295 Unit 4 <br /> n st�1 S D zrsToN i/� SU <br /> Kit 5 <br /> s. sUeel � <br /> 10. Streal A <br /> ENVIRON1(WAL HEALTH DEPARTMENT FILES <br /> lIP sTTE OPj ❑ 1lOUSlNG ABATEMENT Cosan WASTE FACII-T <br /> Le�l�yND�ERGROUND TANK NST)C1. M ❑ FOOD FAC1LlTY 0 SOLID WAS VF_HICLE <br /> iS OTHER a.EmuP srrE iNON-.OP) O DAIRY <br /> t l UNDERGROUND TANK(NIOMOWNGIREMOVAL) G DOG KEINE ra PKG TREATMENT PLANT <br /> C3 HAZAFWOUS WASTE GENERATOR C3 CHICKEN PANCH 0 PUMPER TRUCKNAMICHF.M TQILETS <br /> 0 neRED PERMrrrED FACILITY 0 MOTELAtOTEL 0 Lp,lyp USE APPUCATION Sn'>w5 <br /> 0 TATTOOMODYWERWNG 0Po Ipt�gSESPECIFY? <br /> MEDICAL WASTE FAWLi rY <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the llst above by checking <br /> least one file type MUST be selected. Fax to 20g 4!!A-&138 v "sl to the <br /> the approptiata 15040s)-(es). At <br /> address Indleate a eve. <br /> 2, EMD will notify the apPlicant if any EMD files exjst. An appointment far 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 flue business days for review. Appointments should be scheduled <br /> aecordInglY <br /> tiv <br /> 3. A.fi1e that Is acely being worked on by EHD staff may not b9 Immediately3Vailable'far,review- A ne, ; <br /> application may be submitted whorl the file is available. the <br /> 4. Any file not returned in the same condition as released will 6e reorganized 3�0Hdeposit <br /> D staffiitaprior to rpevie <br /> of the applicant. Future filo reviem by the same applicant may re4ulre a$ P <br /> 5. "TENTATIVE appointment dates must ba confirmed v+ritl7 EHD staff. <br /> 0. Applications received after 3:04 pm will be processed the next business d <br /> ay. <br /> TIME <br /> GONFIR ED A,PPoiNTMENT-DATE <br /> bArE GGHFIRIV tD 'PHONE . FAX' :�IITIALS <br /> 'REVIEWED , YES NO REVIEW DATE' <br /> e„o.a•ox.aaa - <br /> Werzoos - <br />