Laserfiche WebLink
SANT QEIIN CCUNTYPUBLIC �� <br /> ' HEALTH SEICES <br /> ENVIRONMENTAL HEALTH DIVISION i1ff`��� C' � <br /> 304 T WEBER AVENUE,THIRD FLOOR 9j1_!� Fir <br /> Q o , <br /> SToc�K�TI 4� 8 3A42Qzt72 v .. <br /> L 1 PUBLJ RECORDS RELEASE APPLICATION MR t G 2, ?G,�� <br /> { . .. ....., L.LrAl TH <br /> APPI_ICRiMFr C' 5i13tNESrtAGF1v4:Y <br /> ADDRESS Hl�l1 Q.Y t 44 e <br /> PHp7LE 7, f L T <br /> FACSmA1L.E <br /> TENTATIVE-APPOINTMENT DATE TWE <br /> (MRaBe give 7 W tO bvairm=dap&Imm Gain of applic2dan submit <br /> © CMECK BOX TO FXPE:DM9 REGUE5T-STILOO FEE—f;E0LjF3T PROCESSED IN 3 BUSINESS DAY6 <br /> StGkAT'URE OF APPLICANT DATE ©� <br /> Y /�' ) <br /> FW a-, <br /> Wr <br /> :.t.YC•.. "r' �, �1�ib il.i �� FIxN ST�W � <br /> •f <br /> CKVIRONiil ENTAL HEALTH D11#1510N FILES <br /> �FJHDFRGeROUNp TAHr,(usT)CLE.ANvp SCru(LOP) G HOLISM ABATEMENT 0 &0uu IFASTE FACILRY <br /> pl ER CLEANUP SITE 04ON-LOP) 0 FOOD FACtLfry 0 SOUnWASTE VEMCLE <br /> 6� ERGRouND TANK(W10f ITORl QM_EM0vAQ C7 BOG KENNLrL C! DAIRY <br /> fiA2A ?p[LS WASTE GENERAT()R O CHLCKEN RANCH ❑ 1 KG Tit£ATMENTFfAI'I;T <br /> 0 TIERED PEl7MMED FACILITY ❑ MQXUIHOTEL L7 PUMPER TRUCKJYAlialC#iEM TO"—TS <br /> C2 TATTCX)j50DYPEtRZrNG 13 PQOLJSPA ❑ LAND UstAYPLICATmwstTES <br /> ]a MEZWAL WAM FACU ry O PV8lJC WAFcR SYSTEM E3 MuEx(PL.FA¢SMCIFY ASCVE) <br /> I. List sip t4 ten addresses in Ow Space above. Select the typos)of files from the Itst above by checking <br /> the appMpriata box(es), At least Ona file type MUST be sslectad. iia pr mail to thy <br /> jaddreis5.indi t ve <br /> 2• EHD will notify the applicant if any Eho files ezi.t An appointMant for review will tire corfirrned <br /> aQprcq(mately five puniness data but no later than ten (10)days afWr receipt of application. The files <br /> 'Will be held fora maximum of five business day,for review, AppointMents should be scheduled <br /> prGc4rdipgl}r. <br /> 3• A file that is actively being worked on by EHO staff may not be ImiTtedateiy available for review, A new <br /> application may be submitted vthon the file is avallable. <br /> 4. Any file not MUM in tho same condition as released will be reorganized by EHO staff at the o"Onso <br /> of the applicant Future file reviews by the same applicant assay require a$76XG deposit prior to review. <br /> 5- �TENTATWE appraintmertt bates must be cordUnled with EHD staff. . <br /> 6. Application3 recetftd after 3:00 pm wnl be processed the next h isiness day, <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE G014FFRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW OATS <br /> m. <br /> TOTAL P.02 <br />