Laserfiche WebLink
10/21/2004 16:12 FAX 209 9480 002 <br /> ATE RECENEQ - <br /> ►SAN JOAQUIN COUNTX <br /> Ew ktom iENTAL$EALT)a DEPARTMENT _ <br /> 304 EWeber-Ave 3"Floor Stockton,GA 95205 <br /> (209) 468-3420 Fax: (209)464-0138 Web:www.co.sanjoaquimmus/ehd <br /> OCT 2 1 2004 <br /> rUBLIC RECORDS RELEASE APPLICATION <br /> i'l�pl�`-r r •C�y�.43n. :7's o�iUS _ _EUSIfZE551AGE1iGY: r7/� � ' <br /> ADDRESS: <br /> PRONE: 01CR/ qq-x `' FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE: lime: /altA7 <br /> i <br /> (Please allow 10 business days from date of application submittal) <br /> Q CHECK BOX TO EXPEpn-E REQUFST-$93.04 FEE--REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APP41CANT ° DATE <br /> Deaaearont Use Only <br /> FILE ADDRESS UNrr <br /> 1. s QO T + 'ILA b" r <br /> 13 Unit t <br /> 2. <br /> 3. 361W Unit 2 ' <br /> 4 Skael CRY <br /> s. -Sbvet Unit 3 <br /> cry <br /> kCe 7 s� Unit 4 <br /> a" Vxrct <br /> 9. succi - flit 5 <br /> 10. Sad' 6 _1 <br /> ale <br /> EWRONMENTAL NEALTH DEPARTMENT FILES V <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING A$ATEAIENT i9L Soup WASTE FACILrTY <br /> OTHER CLEANUP SATE(NON-4-OP) ❑ FOOD FACILMY ❑ 50LSD WASTE VEHICLE <br /> ISF UNDERGROUND TANK(MQNITOPUNGI119MOVA1a 13 DOG KENNEL IE-DAIRY <br /> Z HAZPJWOUS WASTE GENERATOR 0 CHICKEN RANCH 1RLPKG TREATME>!rt'PLANT <br /> Q TIERED PERMITTED FACILITY ❑ MOTELAiOTEL 13 PUMPER TRUCKIYARDICHEM TOILETS � <br /> to TAT-ro=ODY PIERCING. O POOUSPA % LAND USE APPLICATION VMS <br /> 0 14 EDICAL_WASTE FACIt.rrY 17 OTHER(PLEASE SPECK <br /> 1. Ust up to ten addresses in the space above. Select the type(s)of files from the list aboye by checking <br /> the appropriate box(eS). At least one file type MUST be selected. Fax to(2091464-0138 or mail to the <br /> address indicated above. <br /> 2. EH11 will notify the applicant if any EHD files exist. Art 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 be held 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 EHD staff May not be immediately available for review. A neV <br /> application may be submitted When the file is available. <br /> 4. AAy file not returned In the same condition as released will be reorganized by EHD staff at the eXpensr <br /> of the applicant. Future file reviews by the sante applicant may require a$93.00 deposit prior to review <br /> 5, *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> g. Application's received after 3:00 pm will be processed the next business day. , <br /> .�, ,,, •TIME ",��%• - .. 7 :. <br /> ':CONE:(�MEC]•A_1?POINTM�NT'DATE:, .,�w:�';�: .• ^: �ti�.�V;' ;: r �,'. -".:• , <br /> .:`Q[�FIR14lEG; ` -s-l'HON>= . FAX'' :'�` -.:s.�Nf1ALS' <br /> TEC 1 <br /> f21=V1.MEQ YES No REVIEW DATE' <br /> Eno 0-02-00e <br /> .uartan3 _ <br />