Laserfiche WebLink
05/19/2004 10:41 FAX 209 948Oe9 <br /> DATE RECEIVED la 002 <br /> 1- - <br /> / SAN JOAQUIN COUNTY <br /> J �jNVIRONivINNT-AL HEALTH DEPARTMENT <br /> 304 E Weber Ave 3`1 Floor Stockton, CA 95205 <br /> MAY 19 20f' 9)468-3420 Fay: (209)464-0138 Web:Www.co.san joaquin.ca-uyehd HE gq <br /> ENVIRUNMENT I <br /> HEALTH PTJBLIC RECORDS RELEASE APPLICATION <br /> CTON <br /> APPLICANT: pIdo <br /> - DUSINESWAGENCY: �( <br /> ADDRESS: CP pa �'�IL �j <br /> PHONE: 0� 4- 9yg' FACSIMI E: Q — SCJ' O6 T <br /> TENTATIVE*APPOINTMENT DATE: �P 0� (1iL <br /> (Please allow to business days from date of apPllcatian submitat) <br /> 0 CHECK BOX TO EXPEDITE REQUEST-$93.00 FEE—REQUEST PROCESSED M 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT �aat�os �OQvL` DATE � l�( � <br /> Depar4nent Use Only <br /> FlLE ADDRESS rI�" UNI <br /> 17160 4r <br /> z sine * ❑ Unit 1 <br /> 000 Unit 2 <br /> 5 Shed <br /> s. soeel Unit 3 (tel!,�Q'' <br /> UnR 4 <br /> 9. SYe l <br /> ,c. saw ❑ Unit 5 ItA <br /> City 1�01ull�jilr ILI!m '111 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> OWER CLEANUP SITE(NON-LOP) ❑ FOOD FACH-" ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONrrORINGlREMOVAL) [] DOG KENNEL ❑ DAIRY <br /> "AZARDOOS'WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> PERMITTED FACILITY [7 M07ELA10TEL ❑ PUMPER TRUCMARDICHEM TOILETS <br /> ❑ 7ATTOOLWAST 1ERCILI ❑ POOLISPA )(LAND USE APPLICATION SITES <br /> ❑ MEbIC/u_WASTE FACILrfY ❑ OTHER(PLEASE SPECIFIC <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list aboye 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 /> addressindicated above <br /> 2. EHD will notify the applicant if any EHD Tiles 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. Afile 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 END 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 /> CONFIRM D; P.OINTMENTUATE:.'.[i ..TIME 6rv:•.t':' t +..:i <br /> d7ATE40NFlFtIS7ED: 'PHONE : FAX <br /> REVIEWED YES NO REVIEW DATE :• <br /> FJIp Gt-0Zdas <br />