Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
09/02/2006 09:22 FAX • [Z-oo2/OC2 <br /> 4�RTE RECEIVE1 <br /> SAN .TOAf1Uiti COLiN-rY (0ECENED <br /> EN`-IRO MENTAL, REAITFT DFTAR"T`h ENT <br /> 304 E Weber Ave 3''1 FlOOr Stockton, CA 95205 AUG 0 2 2006 <br /> A' <br /> ('?09) 46S•3420 Fax: (209) 464.01 is Web:ca'A-Vv.CO.San j'Oaquia.ca-&e'��� <br /> ENVIRAMENTHEALTH <br /> PUBLIC RECORDS RELEASE APPLICAII <br /> APPL1CANi:,_ Yr(N i f:CSt ys OUSINESSIAGENCy: <br /> ADDRESS: <br /> PHONE: 04 9 {,�„ FACSIMILE; r, � `ZJ$j• J�p�( T" <br /> TENTATIVE'APPOINTMENT DATE; ��.✓l <br /> (Please allose 10 husiness day-from date of applilatian subm(tul) <br /> CHECK COX TO EXPEDITE REQUEST,$93,00 FEE-REQUEST PROCESSLo IN 3 BusINESS DAYS <br /> SIGNATURE OF APPLICANT DATE I� <br /> D1;0Q0 Ilan(UuL Only <br /> FILE ADDRESS <br /> :. :,Ia M1 2 +Yv+. . a ..,^ ,❑ Unit t.. .ifMl ��- „• <br /> Cib YY Unit 2 <br /> I Q <br /> G ".. Unita <br /> G <br /> e. ^w P©K—f�P4 4�i11I —� Unit A 1 <br /> r, s ��rYt 4t:.� —..;° _ .._ ❑ Unit 5 <br /> ,e. gem <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES ��Ln1tU <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT 11C SOLID WASTE FACILITY <br /> OTHER CLEANUP SAE(NON-Lop) Gt FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> Gl UNDERGROUND TANK(MONtTORING/F2F,MOVAI.j ❑ DOC KENNEL g DAIRY _ <br /> ffi HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH CS-PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTEVHOTEL ❑ PUMPER TRUCKIYARD/CHEM TOILETS <br /> ❑ TATTOOBODY PIERCING ❑ POOIJSPA V- LAND USC APPLICATION SITES <br /> ❑ MEDICAL WASTr FACILITC1'( OTHER(PLEASE SPECIFY) PLIC <br /> .,PLIC._..............-_ <br /> 7. List tip 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. Fox to 12091 46d-0118 or mai( tothe <br /> address indicated above.. _ <br /> 2. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately five businca days but 110 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 availabia 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 $93.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> G. Applications received after 3:00 pm will be processed the next business day. <br /> GONRRMED APPOINTMENT DATE' TIME <br /> DATE CONFiRMED PHONF PAX INICIALS <br /> R@ViEVJC.D YES NO REVIEW DATE <br />