Laserfiche WebLink
10/04%2002 11:12 209-579-2225 <br /> P10DEST0 ATC PAGE 01 <br /> SAN JOAQUIN NMUNTAL HE C HEALTH SERVICES <br /> j ENVIRONMENTAL HEALTH DIVISION '11••1•,l„•1"-1i11• <br /> 304 EAST WEBER AVENUE.THIRD FLOOR A0020 <br /> STOCKTON Gq 85202 <br /> (209) 468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT J:•,., K h ert <br /> ADDRESS I(('� ` .IBUSINE55)AGENCY 4TC <br /> Oh¢ p It- f lie � r <br /> PHONE Oq S ��� To C <br /> t-9- z22( s <br /> • FgCSIMILL' �- 22z5 <br /> TENTATIVE"APPOINTMENT DATE <br /> fU -zl -U2 <br /> (pleas'el '7 to,o bu-ines- ays rr Ual'o TIME /O Mt PF_RMIT/ TH <br /> PPII'atlon subm�Ral) SERVICES <br /> CHECK BOX TO•EXPEDITE REQUEST. <br /> . 0 FC�REQ ST P1�SE N J BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ���'�� <br /> / DATE /U-¢ 02- <br /> FILE <br /> ZFILE ADDRESS <br /> .a <br /> THIS SIO[EHD STAFF USE ONLY <br /> o Md Gveer /5 S I �d PROGRAM ELL'MENTS SEARCH <br /> .l .o Fwrw•S S�Sg C� .( s• A C <br /> JCCr oM V S k ✓ <br /> s� z353 <br /> 7� I !e, or yS O Treti E <br /> 235cv a,s N R Tra <br /> Trac <br /> RM 3 35o Tr,c <br /> lo,ir Yr�ki•+ 8 S• Tva <br /> 'Itv 'c Z45 M yr r,s. 7 <br /> a. <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> yld UNDERGROUND TANK(UST)CLEANUP SITE(LOP) O HOUSING ABATEMENT <br /> OTHER CLEANUP SITE(NON-LOP) O <br /> UNOERGROUND TANK(MONITORING/RCMOVAL] O FOOD DOG FACIUTy SOLID WASTE FACILITY <br /> O HAZARDOUS WASTE GENERATOR O SOLID WASTE VEHICLC <br /> O TIERED PERMITT44 D FACILITY O CHICKEN RANCH l7 DAIRY <br /> O TATTOO/BODY PdI1iCING 0 tAOTEUHOTEL O PKG TREATMENT PLANT <br /> POOLISPA O PUMPER TRUCK/YARD/CHEM TOILETS <br /> 0 MEDICAL WgS7L FACILITY '� <br /> 0 PUBLIC WATCH SYSTEM aLAND USE APPLICATION SITES <br /> List <br /> 1 OTHER(PLEASE SPECIFY ABOVE) <br /> up to.ten addresses 0 in the space above. Select the type(s) of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selectad. Fax to (209) 464-0138 Dr mail to the <br /> address indicated bove. <br /> 2• EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ton (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 new <br /> application may be submitted when the file is available. <br /> 4. Any file not rcturncd in the same Condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Future filo reviews by the <br /> 5• "TENTATIVE appointment dates must be same applicant may require a ;87.00 deposit prior to review. <br /> confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE <br /> DATE CONFIRMED TIME <br /> REVIEWED <br /> PHONE FAX INITIALS <br /> en oo I� roo NO REVIEW DATF <br /> e <br />