Laserfiche WebLink
VNIC KCVOVCV <br /> SAN JOAQUIN COUNTY <br /> EN\-rcONMENTAL HEALTH DEPARTN eNT <br /> 304 E Weber Ave 3'd Floor Stockton, CA 95205 <br /> ILI, <br /> (209) 468-3420 Fax: (209) 464-0138 Web:www.co.san-joaququinin.ca.us/ehd <br /> PUBLIC <br /> /�RECORDS <br /> RELEASE APPLICATION I <br /> cAPPLICANT: S cogql r!q h �' I BUSINESSIAGENCY:/ <br /> ADDRESS: �/� U. RP C C /L 4-7,- <br /> PHONE: ZS ! 0 FACSIMILE: <br /> TENTATIVE`APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal) <br /> 13 CHECK BOX TO EXPEDITE REQUEST-S9 �� EE-REQUEST PRO ESSED IN 3 BUSINESS DAYS <br /> 3 c <br /> SIGNATURE OF APPLICANT it ''%1/L/�1rn�1 c ( DATE %z <br /> j <br /> Department Use Only <br /> FILE ADDRESS UNIT <br /> 35zvrC <br /> see S' 5 ou , 7 e 6 i i CL--f •J ❑ Unit 1 <br /> 29506ceelsees ❑ Unit 2 - CA'S� CRY <br /> seesUnit 3 sees. seen Unit 4 <br /> e. Seen <br /> a. s„tt, ❑ Unit 5 <br /> 10. so- CAY <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> A UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTEL/HOTEL ❑ PUMPER TRUCKfYAR=HEM TOILETS <br /> ❑ TATTOOIBODY PIERCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <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 to the <br /> address indicated above. <br /> 2. END will notify the applicant if any EHD files 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 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 /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME - <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EHD 4au24as - <br /> eierzaoa <br />