Laserfiche WebLink
03/29/2002 16:01 20946-1�3 AGE STOCKTON PAGE 01/01 <br /> DATE RECEIVED tnu wu numaen <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> T WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 n <br /> (209)468-3420 <br /> 14 <br /> P BLl RECORDS RELEASE A T _- IIII <br /> APPLICANT USINI~SS/AGENCY +Y <br /> ADDRESS N OZ <br /> PHONE FACSIMILE ^'')/��y <br /> PCW TIME (/�•l/l� �r � JI,1 `' ,,. -c <br /> TENTATIVE*APPOINTMENT DAYS -- ca on submittal <br /> ' (Please e 7 0'0 s[noas da om d f app ) <br /> CHECK BOX TO EXPEDITE REQU T-$7 .00 FEE REQU C t3 INESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> FILE ADDRESS <br /> It 11 , <br /> r7 I It tt <br /> tt to t 3Sa- <br /> t k <br /> ENVIRONMENTAL_HEALTH DIVISION FILES <br /> UNDERGROUND TANK(usT)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT M SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL D DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> TIERED PERMITTED FACILITY Q MOTEUHOTEL ❑ PUMPER TRUCK/YARDICHEM TOILETS <br /> ❑ TATTOO/BODY PEIRCING ❑ POOUSPA Q LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses 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 selected. Fax to (209)464-0138 or mail to the <br /> address indicated above <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 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 new <br /> application may be submitted when the file is available. <br /> 4. Any file nut returned In the same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a$78.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED _ PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EH 09 a azraar U <br />