Laserfiche WebLink
09/17\/2003 09:37 FAX 209 9480021 . _ Z004/004 „ <br /> OATS �� F)10 LAG Numm <br /> I.V/I —f SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> ��IUB ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBERTHIRD FLOOR <br /> SEP 1 7 2003 sTocKTON K-roN CA ca 95202 <br /> (209) 468-3420 <br /> _NViRuN1AFN r HEM i PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT J 1 BUSINES51AGENCY K•�n r.L Il <br /> ADDRESS <br /> PHONE Ztcl a14f0 13N S FACSIMILE 2❑tet 06 '- �'�' <br /> TENTATIVE"APPOINTMENT DATE fZ�/ TIME OL7 <br /> (Please give 7 to 10 business days from date of application submittal) ' ' /w■� <br /> CHECK BOX TO EXPEDITE REQUEST-$87.00 QUEST P CESSED IN J BUSINESS DAYS /`' <br /> SIGNATURE OF APPLICANT DATE V_`M`/ <br /> 4C � <br /> FILE ADORESs THIS SIDE EHD STAFF USE ONLY O <br /> PROGRAM ELEMENTS SEARCH <br /> LIOLiD 14. -s- L nom, v <br /> o 0 J 57, n , <br /> 141 11 <br /> I L1 3 Lr <br /> 3 Li z N - wtLsotit WA - <br /> � <br /> 32 li L <br /> 33 � d 4,f n :� '' L1 y�,�—f:�� � 1�%% li✓1c- ,—!' .��T i ��;.• �� i1,, <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> YA UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ID SOLID WASTE FACILITY <br /> f�' OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> q UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL IM DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH 0 PKG TREATMENT PUNT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTEUHOTEL ❑ PUMPER TRUCKlYARD/cHEM TOILETS <br /> TATTOOISOOY PEIRCING ❑ POOtlSPA "• kI'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) 464.0138 Or mail tot e <br /> Address Indicated above. . <br /> 2, EHD will notify the applicant if any EHD riles 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 to 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 EHD staff. <br /> 6. Applications received after 3;00 pm will be processed the next business day. <br /> CONFIRME=D APPOINTMENT DATE TIME. <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br />