Laserfiche WebLink
5AN JOAQUIN I.OUIN IA <br />DJ <br />EN&RONMENTAL HEALTH DEPAR i ,NT <br />3 Weber Ave 3`d Floor Stockton, CA 915 <br />APR 0 6 ?N) 468-3420 Fax: (209) 464-0138 Web: www.co.san-joaquin.ca.us/ehd <br />ENViRvu't!ILiJ I HtALTH <br />pGc"j11T/SERVIC PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: ], rv+^Je-'-t— <br />BUSINESSIAGENCY: ATC HSsoci,�er <br />ADDRESS: 111 LOh� Pp�'^. Ave Svlel 111-10d,4v CA <br />PHONE: �-0cl " S� 9" Z2� 1 FACSIMILE: �J9' S 7�`1-22 25 1e <br />TENTATIVE* APPOINTMENT DATE: <br />Time: <br />(Please allow 10 business days from date of application submittal) <br />CHECK BOX TO EXPEDITE REQUEST - $93.00 FEE - REQUEST PROCESSED IN 3 BUSINESS DAYS ^/ <br />SIGNATURE OF APPLICANT DATE <" <br />1. Street V I I <br />2, Street O 6 o 6 <br />3. Street 1110 <br />4. Street 6 1 z2— <br />7. Street 5503 <br />S. Street <br />9. Street <br />10. Street <br />FILE ADDRESS <br />o <br />h <br />Department Use Onl <br />UNIT <br />❑ Unit 1 <br />S. �iv ot• W. I X city Sfoak ) Unit 2 <br />cityS f� O A <br />city Stb,Unit 3 <br />r, i*. -1c�/ ITz�'� <br />S . Ai✓bo� l h/ <br />i✓ <br />S t - <br />S• A-mp o -f -Q- i ` C ry US "1- 3 5 a&!�► �1.- I ❑ <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />4 <br />Unit 5 <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) <br />❑ <br />HOUSING ABATEMENT <br />SOLID WASTE_FACILRY, <` <br />OTHER CLEANUP SITE (NON -LOP) <br />11 <br />FOOD FACILITY <br />11 SOLID WASTE V�ICL14 <br />13 DAIRY <br />UNDERGROUND TANK (MONITORINGIREMOVAL) <br />11 <br />11CHICKEN <br />DOG KENNEL <br />RANCH <br />13PKG TREATMENT PLANT <br />HAZARDOUS WASTE GENERATOR <br />❑ <br />MOTEUHOTEL <br />13 PUMPER TRUCK/YARD/CHEM TOILETS <br />❑ TIERED PERMITTED FACILITY <br />13 <br />POOL/SPA <br />CI LAND USE APPLICATION SITES <br />❑ TATTOO/BODY PIERCING <br />❑ MEDICAL WASTE FACILITY <br />❑ <br />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 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 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 da <br />CONFIRMED APPOINTMENT DATE <br />TIME _- <br />DATE CONFIRMED <br />PHONE FAX' " <br />INITIALS <br />REVIEWED YES NO REVIEW DATE <br />8!812003 <br />