Laserfiche WebLink
08/09/2004 12:13 ATC 2CIRTES 4 12094640138 NO.936 D8 <br /> DATE RSPEHO LOG NUMBER <br /> SAN JOAQuIN COUNTY <br /> L ENVIRONMI NTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave P Floor Stockton, CA 95205 <br /> p�G fl (209)468-3420 Fax: (209)464-6138 Web: www.co.sanjoaquin.ca.us/chd lqq3 <br /> �w1KONM���\10Es PUBLIC RECORDS RELEASE APPLICATION <br /> P APPLICAKT:-LI 8n 1 SUSINESSIAGENCY._ �C <br /> ADDRESS: Ca yl. dp <br /> PHONE: FAC9f#IILE; 2 C- 'Ila - z5 <br /> TENTATIVE`APPOINTMENT DATE: -7n Tlmo: ILI r COPY <br /> (Pteaso allow 10 buslnass days hrGm data of appliratlan autimiMI) <br /> CHECK BOX TO EXPEDITE REQUEST-S FEE-REQUEST PROCESSED IH 8 BUSINESS GAYS <br /> SIGNATURE OF APPUCANT DATE <br /> Delpa"nt Usa Only <br /> FILDORESS UNIT <br /> a Unit t <br /> 7 Snef ai c.I.L-.Io V <br /> #� f H C l F� G c- . U nit 2 <br /> Street <br /> a strew Unit 3 <br /> '' s°"' Unit 4 L� <br /> v sysec ❑ Unit 5 I <br /> sa Seen <br /> CRY <br /> ENVIRONMENTAL_HEALTH DEPARTMENT FILES <br /> it &A * <br /> UNDERGROUND TANK(U$T)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT SOLID WASTE FACILITY <br /> OTHER CLEMUP$rTE(NO14-4-OP) 0 FOOD FACILITY SOLID WASTE VEHICLE LL 1 <br /> 10 UNDERGROUND TANK(M10NTT0RJNGMr:MOVAL) Cd DOG KENNEL DAIRY Irl <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH 76`d PKG TREATMENT PLANT ��0 <br /> TIERED PERMITTED FACILITY MOTFU'HOTEL PUMPER TRUCIVYAR01CHE41 TOILETS <br /> 13TATT00l80DY PIERCING 0 POOLISPA C] LANO USE APPLICATION SITES � <br /> b MI <br /> / MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) 7 � <br /> I. List up to ten addresses in the space above. Select the type(s)of flies from the list above by checking <br /> the appropriate box(es). At least one file typo MUST be selected. Fax to(209)46"138 or mail to the <br /> address Irrdlcated above. <br /> 2. EHD will notify the applicant If any EMD(Iles 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 far review. Appointments should be scheduled I <br /> accordingly. i <br /> 3. A file that Is actively being worked on try EHD staff may not be Immediately available for review. A new <br /> applicatkm may be submitted when the file Is available. ' <br /> 4. Any file not returned kI the same condition as released will be reorganlxed by EHD staff at the expense <br /> of the appllcant_ Future file reviews by the same applicant may require a$93.00 deposit prior to r,avlelnr. <br /> 5. `TENTATIVE appointment dates must be confirmed with EHD staff. <br /> S. Appilcatlons 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 /> EMp 4L-01-0Oi ', <br /> 44fAW7 <br />