Laserfiche WebLink
UAT �Cr�YEU pl6 LCG ryUNBEp <br /> USAN JOJUIN COUNTYPUBLIC HEALTH S1ICES <br /> E VIRON1YIEfYTAL HEALTH DIVI51ON (pG C <br /> AUC 2 4 2001 `, 304 EAST WEBER AVENUE,TH(RDFLOOR <br /> STOCKTON CA 95202 / <br /> _i � (209)468-3420 <br /> ' PUBLIC RECORDS RE[..EASE APPLICAT1iON <br /> APPLICANT IYIa�iILlt•o. iN <br /> S BUSESSIAGENCY `O%&Aor Ear't`h. <br /> ADDRESS ISS 1-eO0. t W.z.si- C.;rCl,2. mow.: �--s. T � /-- <br /> PHONE 2.0701 - 2.3'1 - OSf g FACSIMILE 20'I -234 - 09-18 <br /> TENTATIVE*APPoLNTMENTDATE 8&to--Dot TIME g;$o A M <br /> (Please give 7 to 10 business days from date of appikation submittal) <br /> L/NiTS .?, Zf <br /> © CHECK BOX TO EXPEDITE REQUEST-$87,00 FEE-REQU ST P11CESS W 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> FILE ADDRESS THIS SIDE FHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> ,r 1155T <br /> r ny i R r� 4 etiti O <br /> i fr ,Ca�ksf' <br /> e.S Rd <br /> ttRo � • Mss-�L, i ar ai <br /> t b <br /> t t AA _ D <br /> p t 2 0 1 A o.rc 1. O <br /> $so Ln z 01 O <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> >9/UNDEROROUND TANK(UST)CLEANUP SITE(LOP) 13 HOMING ABATEMENT M SOLID WASTE FAc7LrrY <br /> g OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE V5HtCLJ: <br /> 93�yNDERG ROUND TANK(MONIfORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> F-r HAZAROOUS WASTE GENERATOR L7 CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMILTED FACILITY ❑ MOTELIHOTEL Cl PUMPER TRUCWYARDICHEM TOILETS <br /> ❑�TATTOCISODY PEIRCING ❑ POOUSPA ❑ LAND USE APPLICATION STYES <br /> W MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above Select the types)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(299)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 maxim um 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$87.00 deposit prior to review. <br /> 5. "TENTATIVE appointment dates must be confirmed with EHO staff. <br /> 6_ Applications received after 3:00 pm will be processed the next business day, <br /> CONFIRMED APPOINTMENT DATE TIlr1E <br /> DATE CONFIRMED PHONE FAX INITIALS <br />