Laserfiche WebLink
I[ 08-14-2 1j'09:23PI1 FR TO 7145,134723 F'.01 <br /> SAN JOAQUIN COUNTYPU$tr1C HEALTH SERVICES <br /> AUG 1 4.1U0I ENVIRONMENTAL HEALTH DIVISION <br /> 304 CAST WEL3ER AVENUE,THIRD FLOOR �`JJ <br /> I 1 't I �` 1� 5TOCKTON CA 952OZ <br /> E(�V I R O V b ; (209)468-3420 <br /> PER1Ti`-1L�� 'li-.`� _ PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICAIVT.LVKE MONTt!gagz. DUSINErSSIAGENCY_ my .it•�SI �tJC. <br /> ADDRESS(PKI) 4-t� STREF-l, .c�,it?�, L �l r`���1kt��TA1 ALMA _fX1101 <br /> PHONE_i `T�✓T t ?- r•ACSIMMILLE I�t-� �/�t'J�'T n Z7 2 <br /> TI V G'APPOINYmt-i4T I)ATE I t-1 , &n. t 20c it tlbtC _fYy10r q n <br /> (P1ca5C.7ivu 7 to 10 busincsc days from dato of appgcation subm tWl) <br /> fit) <br /> CtItCK DOX TO,EXPEOITE REQUEST W7.00 FEE—REDULST PROCCSSEO JX S 13USINESS DAYS .� <br /> SIGNATURE OF ALPPL.ICANT �,; � o �.'lig DATE itA, 7- <br /> FILE ADDRESS TH15 SIDE EHD SrAt F U5E UNL7 <br /> PROGRAM t:LI:rAL-N rS sE.(2A qr2&�_l I <br /> ARC1c <br /> I � <br /> -290 -�- <br /> ' IniOa 3 Szg I''�Lti. <br /> •1 �9.6 n r>1.�. _ <br /> rru.- <br /> i G26 .35-A7 <br /> CIS <br /> -- 1 0,1 _) <br /> A ENVIRONMENTAL HEALTH DIVISION FILES <br /> w44RGROUND TARK(UST)CLEANUP;SITE(LOP) 0 HOUSING ADAYCNI:NT SOLID WASTE FACILITY <br /> FA OTH$R CLEANUP SITE(NDN-LOP) ❑ FOOD FACILITY 0 SOLID WASTE VEII)CLt; <br /> UNDi RGROUNO TANK(AAONITORINGIREMOVAL) O DOG KENNEL O DAIRY <br /> NAx/IROOUS WASTE GENERATOR ❑ CHICKEN RANCH 0 PKK TREAlMENY PLANT <br /> Cl TieR�O PERACITTED FACKJTY ❑ MOTEUHOTEL O PUMPEK TKUCKlYARVECNGIA TOILETS <br /> 0 TATTOO11300Y F41RC1NG ❑ POOUSPA • ' ❑ LAND USE AWLICATiON SITES <br /> l] MEDT AL WASTE FACILITY O PUBLIC WATER SYSTEM 0 OTHER(PLEASE SPECIFYAllOVE) <br /> List up to tent addresses Ill the space above. Select tno type(s)of files from the list above by checking <br /> I tfic appropriate box(es). At(cast one file type MUST bo selocted. f=ox to f2O9)464-0'138 or mail fo the <br /> I addretss indica Cd Elbove. - <br /> 2. EHV will notify the applicant if any EMD files exist. Ali appointment for review will be confilmenl <br /> approximately five buslnos5 days but no later than ten(10)days after rec®ipt of application. Tlto files <br /> will be hold for a maximum of five business days for review. Appointments should bo sclleduleti <br /> accordingly. <br /> A file that is actively being worked on by F_HO Staff may not be immediately available for rsview. A new <br /> application rrluy ba submittctl whan.the filo is available. <br /> 4. I Any fila not returnael;n tho soma condition as rcicasad will he rcorUanized Uy EKL)staff at the VxpenLe <br /> of the applicant. Future file reviews by the same applicant=y require a$87.00 a¢posit prior to review. <br /> 5. I <br /> ' <br /> TENTATIVE appaintn,ent:dates inust be eanfir1116d with EHD staff. <br /> G. Applications received after 3:00 pm will be processed the next business day, <br /> 1 <br /> CONIFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRmFa PHONE FAX INITIALS <br /> REVIEWF-D YES NO REVIEW IIATF <br /> TOTAL P.©1 <br />