Laserfiche WebLink
-_07/30/2002 13:49 20946711: AGE STOCKTON _ PAGE 02/02 <br /> DATE REGEIVEO ._. <br /> V SAN JOAQUfN COUNTYPUgLIC HEALTH SE:�iGES <br /> • E VIRONMENTAL HEALTH DIVISION <br /> 4 EAST WEBER AVENUE,THIRD Fl."R ge 4WIN <br /> STOCKTON CA 95202 <br /> j s (209)468-3420 (~ <br /> PUBLIC RECORDS RELEASE APPLICATION NE <br /> APPLICANT BUSINESS/AGENCY F <br /> aIM <br /> AUDRESS n /Q <br /> PHONE-CM) h <br /> TENTATIVE"APPOINTMENT DATE V 5 TIME A)O'D - <br /> ,tom/ (Please give 7 l{°t 10�blU�si�e s da fru. data of aP e�allon submittal) <br /> 4tV CHECK BOX TO EXPEDITE REQUE -S 0.00 rEE—RE U NO �I�t1SINESS DAYS n <br /> SIGNATURE OF APPLICANT DATE 30 11 <br /> FILE ADDRESS <br /> FWIL aye <br /> I A c ron -551 <br /> a <br /> V�I t <br /> t� tt It n <br /> I <br /> � r <br /> ✓ ENVIRONMENTAL HEALTH DIVISION FILES romb <br /> N O WI„GI-2- 1J. kAWf� J✓ <br /> UN ERGROUND TANK(UST)CLEANUP SITE(LOP) CI HOUSING ABATE <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE <br /> MENT ❑ SOLID WASTE FACILITY <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑ MOTELTIOTEL O PUMPER TRUCKIYARD/CHEM TOILETS <br /> ❑ TATTOOIBODY PEIRCING ❑ POOIJ5PA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ 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) 464-0113$ or mail to the <br /> address indicated abovq. <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 END 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 $78.00 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 /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> ER oo to otnvaa - <br />