Laserfiche WebLink
07/08/2002 MON 12;50 FAX 916 5654356 f 001/001 <br /> U(/Vb/LCIGL 1n:4ts nb4F ENVIRONMENTAL _TH PAGE 01 <br /> S. JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> I/ 304 EAST WEBER AVENUE,THIRD PLOOk t <br /> STOCKTON CA 95202 <br /> 468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT i4221 <br /> BUSINESSlAL'ENCy .Ct24ccl <br /> ADPRESS / <br /> PHONE N-1 - <br /> _ FACSIMILE <br /> c1.TENTATIVE`APPOINTIACWT DATE r� <br /> O (Please glvo 7 t id PMC <br /> r <br /> s s d appli submtttal) r <br /> CHUCK BOX TO EXPEDITE REQUEST- 9,pa F <br /> -' - E QU ST OCES 113 !NESS DAYS <br /> SIGNP T URE OF APPLICANT _. <br /> C% DATE <br /> FILE ADDRESS THIS SIDE EHD STAFF USE!ONLY <br /> PROGRAM ELEMZNTS SEARCH <br /> O <br /> ti <br /> -14 <br /> �' 6« -✓ N <br /> vvv •W. <br /> Kai- <br /> z� <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> Uf UNDERGROUND TANK(UST)CLEANUP SITE(Ldp) ❑ HOUSING A13ATEMENT 0 SOLID WASTE FACtLrrY <br /> r2OTHER CLEANUP SITE(NON-LOP) 13 FOOD FACILITY 130 UNI)CRGROUND TANK(MONITORtNG/R6MOVAL) Q DOG KENNEL ❑ Da�WASTE VEHICLE <br /> 44 HAZARDOUS WASTE GENERATOR d CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> d TATTOO jaciuy TED FING r(Y ❑ MOTEUHOTEL ❑ PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑ MEDICAL <br /> WAS PEIRCINO D POO�PA M LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WA7CR SYSTEM 0 OTHER(nEAASE SPECIFY ABOVE) <br /> 1• List Up to ten addresses in the space above. Select the types)of files from the list abovo by checking <br /> the appropriate bOX(es). At least 0110 file type MUST be selected. Fax to 209 464-0138 or mall to the <br /> address indicated above <br /> 2- EHD will notify the applicant if arty 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 settle condition AS released will be reorganized by EHD Starr at the expense <br /> Of the applicant. Future file reviews by the same applicant tray require a$89.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates trust be confirmed with EHD staff. <br /> .6. Applications received after 3:00 prn will,be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE. TIME <br /> DATE CONFIRME=D PHONE FAX -INITIALS <br /> REVIVIEWED YES NO REVIEW <br /> nn — <br /> Post-ie Fax Note 767140 _�From <br /> Phone k F-wr.fee <br /> �C/_ Fox• 7(7 <br />