Laserfiche WebLink
-oa 01/2004 13:53 FAX 1 209 234 7727 STOCKTON [7]002/002 <br /> 0n2/26/ 0�4 15:fl8 46(' �8 ENVIROhI 1' ITH PAGE 01 <br /> W L�1]1 �LUJ S.JoAQurnr Cov rr <br /> F-NVIR0'IMENTAL HEALTH DEPARTMENT <br /> MAR 0 1 222299004 304 E Weber Ave 3"Moor Stockton,CA 95245 <br /> ENVIRONMENT'N� P9-3420 Fax: (209)464-0138 Web:www,co.sanjoaquin.ca.us/chd1 '70 7 <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> L Guka�c- tauswEssraaENCY: [�va11acG- +� ftssoG. _ <br /> ADI)RESS: 3'i10 !.J Na.f.I L Ni 'S o 14 <br /> PHONE 0 2 3 — Z Z FACSIMa_E: Z o a) 2,b y — 2 <br /> TENTATIVE"APPOiWMENT DATE: <br /> (Please 00W 10 bus&,ass days from date of MpplicaUon cubmMaQ <br /> CHECK BOX TO EXPEDrIT REQUEST-S P. <br /> DO FEE— PROCF_S$ED IN 3 BUSINESS DAYS <br /> SIGNATURE of APPLICANT A c_ DATE <br /> De"rtnw Use 01ty <br /> FILE ADDRESS UNIT <br /> 1. CRY <br /> V i= I � Z C] unit i <br /> () <br /> LA <br /> a, saeec 12 <br /> ❑ Unit 2 �' <br /> s. csK, 1Ll 1 E1 NrAdc unit 3 <br /> � 3qG 4er ✓ ✓ r4 I- S4 <br /> i, saw <br /> Vj VIX <br /> e, sem, <br /> Unit 4 <br /> 4' s UITit 5 <br /> 10, baeec <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES r� <br /> X UNDERGROUND TANK(UST)cLEANUP SITE(Lop) ❑ HOUSING ABATEMENT O SOLID WAS'TSFACILITY � <br /> 111 OTHER cLEmup SITE(NON.LOp) ❑ FOOD FACILRY ❑ SOUD WASTE VEHICLE <br /> ^UNDERGROUND TANK(MOMTDRUVGIREMOVAL) ❑ DOC KENNEL ❑ DAIRY <br /> ❑ HAZARDOUS WASTE GENERATOR d CtOCICEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TWJtED PERMf1TED FACaITY ❑ MOTELJHOTEL ❑ PUMPER TRUCKIYAPAVC�E1!TOtl-ETs <br /> ❑ TATT0018004f PIERCING 0 POOLISPA ❑ LAND USE APPLICATION srrES <br /> ❑ MEDICAL WASTE FACK rTY 13 OTTiM(PLEASE SPECiFYi <br /> 1. List up to ten addresses in the space above. Setact the typos)of dies from the list aboyo lay checking <br /> the appropriate box(es). Af(east one file type MUST be selected. Fax to(20)464.0138 or mail to the <br /> address Indicated above. <br /> 2. EHD will notify the applicant If any EHD files extst. An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10)days rafter 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 activety being worked on by EHD staff may not be Immediately available for review. A new <br /> applitatlon may be submitted when the file Is available. <br /> 4_ Any file not returned in the same condition ars released will be reorganized by EMP staff at the expense <br /> of tho applicant. Future file reviews by the came applicant may require a$93.00-depoattp4�or tQ ri ll <br /> 5. "TENTATIVE appointment dates most be confinned with EHD staff. "{� T <br /> B- Applications received after 3;00 pm will be processed the next business day f ' J <br /> tiiNF RM>r1:0,-,0, bit*TV1tN'tAT4-. <br /> fAt C.CNFi t,; a:: <br /> �WOtQE <br /> "#2�VIlWVIfED <br /> .'VES No R�MEW DATE <br /> E�+o ta�z.00c <br /> SAMOA - <br />