Laserfiche WebLink
Nov 25 03 10: 45a F--n Chesney 1369-9598 p. 1 <br /> UA1 HLCLIV tIj'' i .--_ EHO�OG NUMBER <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> A-r-rlv: /A2003 ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> 4Fj)iS+=,?1/I( FS (209)468-S� of 6�-al3$ <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT, D/V C�I�SNE BUSINESS/AGENCY Ch`ES�S/� G,O�lSGI r/��J <br /> ADDRESS <br /> PHONE (Pt0 l/ �Y'(/3 FACSIMILE lG <br /> TENTATIVE'APPOINTMENT DATE TIME �I�id <br /> (Please give 7 to 10 business days from date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST- 00 FEE- ST PROCESSED IN 3 BUSINESS DAYS" \_ <br /> SIGNATURE OF APPLICANT DAT!_ l`~ Z 3 -03 <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> } �] >✓ 1 nl fJ a <br /> 23 3 IZgNp Kopcp Lop 1 e "Av6& VAIR <br /> • T ,vV�� <br /> A <br /> ENVIRONMENTAL HEALTH DIVISION FILES ('^v <br /> ❑ UNDERGROUND TANK(US1)CLEANUP SITE(LOP) ❑ HOU51N(i At3A I EMENT 0 SOLID VVASTE FACILMY y krQ, f <br /> 13 OTHER CLEANUP SITE(NON-LOP) 11 FOOD FACILITY 0,SOLID WASTE VEHICLE f N. <br /> 13UNDERGROUND TANK(MONITORfNGIREMOVAL) O DOG KENNEL fT DAIRY �A 1 <br /> 13 HAZARDOUS WASTE GENERATOR D CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILfTY ❑ MOTELlHOTEL ❑ UMpER Tf2UCK/YARDICHEM TOILETS <br /> ❑ TATTOOIBODY PEIRCING U POOLJSPA Iff LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY O PUBLIC WATER SYSTEM O 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 C1�\ <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 hold for a maximum of five business days for review. Appointments should be scheduled J` <br /> accordingly. �y1 <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 returned in the same condition as released will be reorganized by EHL)staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a$89.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff: <br /> 6. Applications received atter 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX R INITIALS <br />