Laserfiche WebLink
10-02-20W PJ8:01PM F* TO • 19256863099 P.Oi <br /> R NEGiJVEO EJ40 11K HY.WIL'R <br /> SAN JOdQUtN COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> J04 EAST WEBER AVENUE,THIM FLOOR <br /> RUSHi STOCKTON CA 9b202 <br /> (209)40-34= <br /> l / {�PIIIBLIC RECORDS RELEASE APPLICATION -� <br /> APPLICANT 1�l V. V ) `�1 .IQ9 �� BUSINES3)AOENCY C() <br /> ADDRESS III ! 0 <br /> g'� i FACSIMILE q SRO o�� <br /> TENTATIVE-APPOi"LNTbATEF{t(AQ.0 9jd•lob" ko TIME 10:3n /r1SFRVi(�FS Ty <br /> j(Please give 7 to 10 bua'ii ss'aans tAxn date of application sWxnhW) <br /> /a1 CHECK BOX TO EXPEDITE REQUEST-557.00 FEE-REQUEST PROCES IN 3 BUSINESS DAYS JJ <br /> SIGNATURE OF APPLICANl1 ;DATE _1�[_3Ao <br /> I ! <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PR9GRAM ELEMENTS SEARCH <br /> 975 F Ic+gr LrI ska,1 4. �— 0 3 <br /> l� r <br /> a Ska•1er S�r <L 0 <br /> fA' n <br /> 3 Z �Z <br /> 415 E finer Sitrk4n CA ' <br /> 991ab Hwq I iciv <br /> 1305 o o v <br /> n I i r ENVIRONMENTAL HEALTH DIVISION FILES <br /> I <br /> SQ UNDERGROUND TANK(UST)C+F_ANUP SITE(LOP) ❑ HOUSING ABATEMENT SgUO WASTE FACILITY <br /> 'lam OTiiER CLEANUP SITE(NON-LOP) 1 d FOOD FACILITY SOLID WASTE VEHICLE <br /> '> -UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL b DAIRY <br /> itHAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH O PKG TREATMENT PLANT <br /> TIERED PERMTriID FACILITY ] 0 MOTELIHOTEL ❑ PUMPER TRUCK/YAROICHEM TOILETS <br /> ❑ TATTOOBODY PEIRCING I ❑ P60LISPA ' " 11.LAND USE APPLICATION S= <br /> -)4 MEDICAL WASTE FACILITY 1 3<PUBUC WATERSYSTW O OTHER(PLEASESPec)FYAaovE) <br /> 1. List up to ten addresses III the space above. Select the types)of files from the list above by checking <br /> the appropriate boxfou). At least one file type MUST be selected. Fax to(209)4640138 or mail to the <br /> addrgr )ndfcated 6b9Ye. ! <br /> 2. EHD will notify tholappliont 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. Appoirnments ahould 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 return�d in the same condition as released Y411 be reorganized by EHl7 staff at the expensa <br /> of the applicant ture file reviews by the same applicant may require a 587.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment!dates must be confirmed with EHD staff. <br /> 5. Applications recei4ed aftc�, 3:00 pm will be processed the next DUSiness day. <br /> I <br /> j I <br /> CONFIRMED APPOINTMENT DAVE TIME <br /> I <br /> DATE CONFIRMED PHONE FAX INITIALS <br />