Laserfiche WebLink
FROM NOA Environmental PHONE NO. : 209 369 4228 Dec. 23 2002 12:25PM P4 <br /> A> ,O QUIN COUNTYPUBLIC HEALTH SERVICES <br /> NVIRONMENTAL HEALTH DI VISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> D E C 2 3 2002 STOCKTON CA 93202 <br /> (209)468-3420 <br /> i:N'V,RoruRUBLIq RECORDS RELEASE-APPLICATION <br /> APPLICANT L lf( _ [ _BUSINESS/AGENCY <br /> ADDRESS ZZ ) . L,q Z 'rj <br /> PHONE 20' 367-3701 ,FACSIMILE. ?aD4c .s' g <br /> TENTATIVE"APPOIN7MENY DATE ^.1• �o Z06 _ �yE Q „ti' , 1-a-V3 7 <br /> (Please give 7 to 10 business days from date of appilca8pn Submittal) <br /> CHECK 9oX TO EXPEDITE REQUEST-$89.00 FEE- RE 135 PROCESSF_D iN 3 BUSINESS DAYS un-. <br /> SIGNATURE OF APPLICANT ,'` <br /> DATE 2^3 . 2--_ • <br /> •. <br /> FILE ADDRESS THIS SIDE VHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> t4d;. C14 <br /> 5 c. Ln .� <br /> j =� �1-i►.x ; <br /> tad C�4 <br /> I�JL � C Q.LrI�L <br /> ENVIRONMENTAL,HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) O HOUSING ABATEMENT O SOLD WASTE FACILITY <br /> IS'OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACUM Q SOLID WASTE VEHIQL- <br /> UNDERGROUND TANK(MONITORING/REMOVAL) 0 DOG KENS O DAIRY <br /> S�HAZARDOUS WASTE GENERATOR O CHICKEN RANCH O PKG TREATNENY PAY <br /> E3 TIERED PERMITTED FACIUTY CI MOTMJHOTEL ❑ PUMPER TRUCWYARD/CHEM TOtLET^, <br /> 13 MEDICAL <br /> WAS PEIRCtNG ❑ POOLISPA 13 LAND USE APPLICATION SRF_S <br /> ❑ MEDICAL WASTE FAC[LtTY ❑ PUBUC WATER SYSTEM lg'OTHER(PLE43C 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 END 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 END 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 EMD 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 />