Laserfiche WebLink
� `` r,--� tnD LOG raurrroel e <br /> ``� If a@ SAN JOAQUIN COU?N'ry <br /> ENV.1RQNM( ENTAL HEALTH DEPARTMENT <br /> Nu V 2 0 2007 304 E Weber Ave 3" Floor Stockton, CA 95205 <br /> NARoiwENT H )468-3420 Fax: (209) 464-0138 Web: www.co.san joaquin..ca_ s <br /> P� 4 <br /> ��11�tiTlSt�iVIC�� <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: /� P_a C.G-z7 - _BUSINESS/AGENCY: /V 1�I 0* A, �,,4s 1'1 + 1 f f coc r (14,C. ' <br /> ADDRESS: 6?D1. <br /> 3�Q' -9-v` FACSIMILE: 7 6 <br /> PHONE, r C Q <br /> TENTATIVE*APPOINTMENT DATE: �` I �a O Time: 1 <br /> (Please allow 10 business days from date of application Submittal) <br /> CHECK BOX TO EXPEDITE REQUEST•$93...00 FEE--REQUEST PROCESSED IN 3 13USINESS DAYS <br /> SIGNATURE OF APPLICANT DATE I �ne p <br /> Department V,-;a Only <br /> FILE ADDRESS UNIT <br /> citv S ❑ Unit 1 <br /> 2. st'e! 39'31 .o.�+0-'-, cit <br /> 3. set 3`� � N, , ti-. ctt [] Unit 2 <br /> 4. str 3�I t o /V . tj c—, � ✓ ct1 <br /> s. street 3� A k5" cit (�( fj�11 Unit 3 \'1i <br /> 6, Slrccl <br /> (AllSV v&AA <br /> n� / � <br /> 7. street �7 nj-2- � , Q Wye, (�{\`�! cn 4 <br /> B, Street 77 L-� ,�f "1__. Qµ31`N� "\-\� City <br /> $. Strata 3 ([--('v •' /�rrr'l-�•��d. CSI edUni' <br /> Unit 5 <br /> 10 5'rmt ��J l,/ /✓U CII •--- <br /> ENVIRONMENTAL HEALTH DEPARTMEN a � ` <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT ❑ SOLID WAS <br /> OTHER CLEANUP SITE(NON,LOP) 13 FOOD FACILITY d SOLID WASTE V CLE <br /> UNDERGROUND TANK(MONFrORING/REMOVAL) © DOG KENNEL C1 DAIRY <br /> H�ARDOUS WASTE GENERATORX a CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> 1 TIERED PERMITTED FACILITY( 0 MOTEL/HOTEL ❑ PUMPER TRUCK/YARDICH5M TOILETS <br /> d TATTOO/BODY PIERCING Q POOLISPA 13 LAND USE APPLICATION 51TES <br /> 0 MEDICAL WASTE FACILITY Q OTHER(PLEASE SPECIFY) <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 <br /> iConfirmed <br /> approximately five business days but no later than ten (10) days after recdipt of application. The file <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 <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 EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a$93.00 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 /> EHD 40-024)06 - <br />