Laserfiche WebLink
SAN J QUIN COUNTYPUBLIC MEALTH S 'ZVICES <br /> 'ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> "'y f 2 Z O J 1 STOCKTON CA 95202 <br /> (209) 468-3420 <br /> - " PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT �JA-J•ft-- HHUSINE/SSIAOENCY C >llO(o //y L flrlt/7fCrobofic'( -er- <br /> ADDRESS �gy�ylir7 ul CJr G-r61i1/ V K�Ti tS>r �/ "! .— '"6 <br /> PHONE e5jDq--V X!Z- Ur B FACSIMILE ��y~��y-2`r t <br /> TENTATIVE'APPOINTMENT DATE S-/-/? 0 / TRAE D M <br /> (Please give 7 to 10 businex days from data of application submittal) IIJf <br /> CHECK BOXTO EXPEDITE REQUEST-$R7-0D FE E—REQUESTPROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE ��F�A <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> aid r <br /> o � c 1.lr hire /J S9Go �3°`� <br /> -4�s lt( 1 o c 2� rn 147 22391, .216ZZ233 ZZ13, .2Fq ,.2310 Z <br /> 2227 <br /> 7 t ro N c 2122!0 <br /> 1ssal L thv <br /> i <br /> �.,/ ENVIRONMENTAL HEALTH DIVISION FILES <br /> y URDERGROUND TANK(UST)CLEANUP$ITC(LOP) ❑ HOUSING ABATEMENT SOLID WASTE FACILITY <br /> ,OTHER CLEANUP SITE(NON-LOP) O FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> J�UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY - ❑ MOTELRtOTEL ❑ PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑ TATTOOIDODY PEIRciuG ❑ POOI.fSPA ' - f g�LAND USE APPLICATION SITES <br /> ❑ MFJDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASESPLCIFY ABOVE) <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) 464-0135 or mail tp. the <br /> address indicated above. <br /> 2. EHD 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 fife 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$87,00 deposit prior to review. <br /> S. '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 /> REVIEWS YES NO REVIEW DATE <br />