Laserfiche WebLink
Ar1TE tttta:veu _ -'. WU l04 NUI mot <br /> � <br /> SAN JcQUIN COUNTYPUBLIC HEALTH :,.RVICES CD.: - <br /> ENVIRONMENTALHEALTH DIVISION <br /> 304 EAST WESER AVENUE,THIRD FLOOR • � {s• <br /> 00 STOCKTON CA 95202ak�2�7 20 01 <br /> (209)4683420 ,�. „,, <br /> PUBLIC RECORDS RELEASE APPL[CATtQt �I VII „ > ti; �.EaLTh <br /> tour ic��sne �sl Yl�ir� R-�� � y_!1�Ili .i.• <br /> APPLICANT QMp� BUSiNESSIAGENCY .� <br /> ADDRESS ��V <br /> PHONE 2241-21 ?tri FACSIMILE <br /> TENTATIVE*APPOINTMENT DATE TIME <br /> (Please give 7 1010 business days from bate of applicatlon submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$87.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT {L11 itr j► BATE <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> 303 i 3.s2g <br /> IM <br /> , CUMC I3S. s? M L <br /> b9 +�� Mtk�.r+ '3s'.�co ►�:� <br /> 0 3s.a9 ot4.G0 n%.. <br /> 1 <br /> NsAi-HE.ALIH DMSION FILES F- - <br /> 'UNDERGROUND TANK(UST)'CLEANUP SITE(LOP) I7 HOUSING ABATEMENT SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON�LOP) 0 FOOD FACILffY ❑ SOLID WASTE VEHICLE <br /> UNOLRGROUND TANK(MONITORINGMR MOVAL) 0 DOG KENNEL 0 DAIRY <br /> J1''HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH I? PKG TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY 0 MOTELIHOTEL © PUMPER TRUCKIYARDICHEM TOILETS <br /> M TATTOO11300Y PEIRCPNG ❑ POOIJSPA .er-LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY I1 OTHER(PLEASE SPECIFY 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 1209)464-0138 or mail to th-Q <br /> address indicated 0.0ye. <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 to 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 el-10 staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a$81.00 deposit prior to review. <br /> 5. "TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 8:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> RFVir-w1P ) YP=A Pun QI=r1>=W nA-rr_ <br />