Laserfiche WebLink
RPR 01 2003 3: 35PM SPca <br /> 510 625 81713 P. 2 <br /> 04/01/2003 15:27 4640136 e E NTA A PAGE 01 <br /> t�MeEP <br /> DATA ItE flrVIEDo , (((''SAN JO CO T� Bl. C ! LTH V <br /> �nENVIRONMENTAL HEALTH DIVIS10 <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> APR 0 1 2003 STOCKTON CA 95202 <br /> (209)468.3420 <br /> ENVIF;UNMENT HEAUIP-IVBLIC RECORDS RELEASE APPLICATION <br /> 11 <br /> — SUSINESSIAGENCY,�1���K <br /> PLICANT <br /> AP1 <br /> ADDRESS // <br /> HONE _ C— fAGSIMII.Ea•C7� <br /> n <br /> E A IVE` ­PVT ME <br /> (P as ve 7 to 10 uslness dapys from date of•pplicatton submittal) <br /> FEET R GUE r PR E53ED 1N J BUSINESS DAYS ! x <br /> C3 CHECK BOX TO EXPEDITE REOUEDATE <br /> �9fi�Q9,if� <br /> SIGNATURE OF APPLICANT r ` <br /> r THIS SIDE EHD STAFFSE ONLY <br /> FILE ADDRESS PROGRAM CLEWENT SEARCH <br /> A <br /> I <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> ,. <SOLID VfAwSTE FA:'LITY <br /> O F <br /> NDERGROUND TANK(usT)CLEANUP SITE(LOP) O FOOD FACILITY <br /> FA CILITY ABATEMENT O SOLID WASTE VE!-IrCLE <br /> p DAIRY tCC3 <br /> THER CLEANUP SITE(NON-LOP) 0 DOG KENNEL p DAG TRI':A PLANT <br /> NDERGROUNDTANK(MONfTORINGlREMOYAL) 0 CHICKEN RANCHAZARDOUS WASTEGENERATOR p IVIOTEUHOTEL O LAND UUm SE APPLICARDICHEM TOILETS <br /> ( LAND VaE APPLiI+iLTION SITES <br /> IERED PERMITTED FACILITY p POOUSPA 0p OTHER IPLEASS SiaE.CIFY ABOUEi <br /> ATTOOi6ODY PEIRCING ❑ <br /> 0 MEDICAL WASTE FACILITY - checking <br /> a s of files from the list above by <br /> MUST be selected. Fax to m 1464•(!138 Dr mail 1 <br /> Llst up to ten addresses in the space above. Select the typ <br /> the appropriate box(es). At least one 1119 type <br /> address Indicated above. Y p ointment for review Will 1;;'cco Confirmed <br /> Thp iliac. <br /> EHD will notify the applicant If an EHD tiles exist. to a10 days after re.eipt of apt <br /> 2- but no later than ten( ) y Ointments should be scheduled <br /> approximately five business days <br /> will be held fora maximum of five business days N Tavinot bePmmcdiately available for review. A new <br /> accordingly. <br /> 3. <br /> A file that is actively being worked on by END eta Y <br /> application may submitted when the tion 1s available• be require a$89.00 deposit prior to review' <br /> An file not returned in the same condition as released same applicant may req ire a$by FHD::tail at the expo <br /> ll <br /> 4. Y <br /> of the applicant. Future file reviews by <br /> g 'TENTATIVE appointment dates mu w11 be process dSthe next business daY• -_ <br /> 6 Applications reCaived after 3:00 pr <br /> TIME --------'�_"`_- <br /> CONFiRMED APPOINTMENT DATE INITIAI_:i --- <br /> PHONE FAX <br /> DATE CONFIRMED REVIEW DATE <br /> 'act <br /> REVIEWED YES NO 5 4,1J <br /> 1 <br />