Laserfiche WebLink
� EHa LOG fM1M6ER <br />SAN <br />ENVIRON,M ENTAL H ALTHDIDIVISI FLORLxViCES <br />STOCKTON CA 95202 <br />(209) 468-3420 <br />`PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT Ma.ri�4l� t'F'1.�4�x-S _ _BUSINESSIAGENCY <br />1 1 <br />ADDRESS M6 r- 'tc c_rr�«c - w -r.c_-.�-�-• ^ .o <br />PHONE 2.09 - 2.5f:j - OS 16 FACSIMILE 2og <br />TENTATIVIE OINTMrNTDATE 11 sja pal TtLA6 <br />(Please"77 to In h !"& days froM date of application subiniLffiI) <br />CHECK BOX TO EXPEDITE REQUEST- 387.000FFEE - R /QUESS PE)7 E 1 3 BUSINEs9 PAYS <br />SIGNATURE OF APPLICANT L 1 � DATE (t 111 xbZ'-j <br />KC. <br />ENVIRONMENTAL HEALTH DIVISION FILES <br />/ <br />Ci yNDFRGPOUND TANK (UST) CLEANUP SITE (LOP) <br />FILE ADDRESS <br />THIS SIDE FJ(D sTAPF US6 ONLY <br />PROGRAM ELFIMENTs SEARCH <br />ER CLEANUP stTE (NON -IAP) <br />-4 2,0Al <br />❑ SOUL) WASTE VEHICLE <br />�ta✓ <br />ERGROUND TANK (MONITORING REMOVAL) - <br />❑ OOG KENNEL <br />O <br />1 -4 <br />'�, <br />P, Y-" %e w N <br />0 TIERED PERMITTED FACILITY <br />0 MOTEL MOTEL <br />0 PUMPER TRUCWYAID)CHEM TOILETS <br />0 TA TTGO1800Y PETRCING <br />l7 POOLI3PA "' <br />M LAND USE SITES <br />5MEDICAL WASTE FACILITY <br />".'�f ^00 <br />9Y <br />�. <br />p. v1��✓It.. r1 <br />�DE1M1O+r a <br />;oA <br />1,11111AIVII IP 11 PHIL <br />ENVIRONMENTAL HEALTH DIVISION FILES <br />/ <br />Ci yNDFRGPOUND TANK (UST) CLEANUP SITE (LOP) <br />El HOUSING ABATEMENT <br />MFOOD <br />C7 SOLID WASTE FACILITY <br />ER CLEANUP stTE (NON -IAP) <br />FACILITY <br />❑ SOUL) WASTE VEHICLE <br />�ta✓ <br />ERGROUND TANK (MONITORING REMOVAL) - <br />❑ OOG KENNEL <br />EI DAIRY <br />�dddddHATARDOUS WASTE GENERATOR <br />13 CHICKEN RANCH <br />❑ PKG TREATMENT PLANT <br />0 TIERED PERMITTED FACILITY <br />0 MOTEL MOTEL <br />0 PUMPER TRUCWYAID)CHEM TOILETS <br />0 TA TTGO1800Y PETRCING <br />l7 POOLI3PA "' <br />M LAND USE SITES <br />5MEDICAL WASTE FACILITY <br />L7 PUBLIC WATER SYSTEM <br />0 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 apove. <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 he 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 $87.00 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 />WNFIRMED APPOINTMENT DATE TIME <br />DATE CONFIRMED PHONE FAX INITIALS <br />