Laserfiche WebLink
04/30/2003 09:42 FAX 209 9480621 <br /> Q1002.(101 <br /> ogre REeEtvev <br /> 'C:')��^ �'1'��(C N JO UIN COUNTYPUBLIC HEALTH SERVICES ENDI,XsnUHBER <br /> ENVIRONMENTAL HEALTH DIVISION <br /> APR 3 0 2003 304 EAST WEBER AVENUE.THiRD FLOOR <br /> STOCKTON CA 95202 <br /> iVV!`r ;i��ll�fEiul HEAL (209)468-•3420 <br /> Z��FLZCE2 E3L1C RECORDS RELEASE APPLICATION <br /> APPLiCANT •% /"/��}+�G�, BUSINESSIAGENCY I-C/-e e r_1 �r- <br /> ADDRESS_ <br /> PHONE /3 c fS FACSIMILE <br /> TENTATIVE*APPOINTMENT DATE 5/_%��'_ 3 TIME <br /> (Please give 7 to 10 business days from date of application submittal) <br /> 13 CHECK BOX TO EXPEDITE REQUEST-$87.00 FEE--REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT <br /> OATE <br /> FILE ADORESS THIS SIDE:EliD S i AFF USE ONLY <br /> PROGW.M ELEMENT'S SEARCH <br /> FR7,66Cour++r Gfvb 7SIV4 <br /> Cbv..f r C/vbCOV-4r-y Ciu.L <br /> Co <br /> w,-1-r• C.v5 /v1 2 - — <br /> fX-5 Y7 s <br /> Co A4-0- V C/GP6 /3-41z— <br /> �o wo% Club aIv,J <br /> Clvb 131vL f7 - <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> .01UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT 0 �Sf►Liq WA ITE FACILITY <br /> ,.gr OTHER TE <br /> .XB NDERGRCLEANUP <br /> ND TANK(MONITORING/REMOVAL) 0 DOGDKENNEL DFACILITYADA Ri'wp� VEHICLE <br /> 0 HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG'rREATMENT PLANT <br /> 0 TIERED PERMITTED KACIUTY iQ MOTEUHOTEL ❑ PUMPER TRUCK/YAROICHEM TOILETS <br /> ❑ TATTOOIBODY PEIRCING ❑ POOLISPA ❑ LE*N[I USE APPLICATION SiTES <br /> ❑ MEDICAL WASTE FACILITY• ❑ PUBLIC WATER SYSTEM O o-rmi:R(PLEA:3E SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above. Select the type(s) of files frc►m the list above by checking <br /> the appropriate box(es). At(east one file type MUST be selected. Fax i:o r209) 464 . 38 or ri o t)te <br /> address indicated above.. <br /> 2. EHD will notify the applicant if any EHD files exist An appointment for revieva will be confirmed <br /> approximately five business days but no later than ten(10)days after Feceipt of application. The file.:; <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. Anew <br /> application may be submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will be reorganiz(A'ble END 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 busine,s day. <br /> CONFIRMED APPOiNTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIA•L.S. _ <br /> REVIEWED YES NO REVIEW DATE <br /> _ f <br />