Laserfiche WebLink
May 28 02 03: 06p Dc Chesney 668-V938 p. 1 <br /> .1•.1 I.I.L..11 111 <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES nC)UCJLE <br /> AT-TN %A �/ ENVIRONMENTAL HEALTH DIVISION <br /> / 304 EAST WEBER AVENUE,THIRD FLOOR MAY 2 $ Z��2 <br /> STOCKTON CA 95202 <br /> (209)468.3420 ENVIRONMENT HEALTI� <br /> PUBLIC RECORDS RELEASE APPLICATION PERMIT/SERVICES <br /> APPLICANT C�{�SA/ 1/ _BUSINESSIAGENCY 5 CO SGlL \' <br /> ADDRESS <br /> PHONE. (��p / Q 3 FACSIMILE C9,g \ • <br /> TENTATIVE"APPOINTMENT nAYF_ TIME <br /> (Plcasa Glyc 71010 buslnaSfrom dfAr AV jk6 applicalion submittal) <br /> CHECK BOX 70 EXPEDITE REQUEST-S .00 FE t t=gUEST PRO S fN J BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 157-2-S3--O 2 <br /> FILE ADDRESS THIS SIDE CHO STAFF USE ONLY <br /> AND PROGRAM ELEMENTS SEARCH <br /> - � DONT A �7ke o � ' <br /> ILIO 7_ 0 H c. iz <br /> Vim, �- <br /> ✓� A 5T ,¢1V,62 egaj1F <br /> ENVIRONMENTAL HEALTH DIVISION FILES �3O 1 -2. <br /> O UNDERGROUND TANK(UST)CLEANUP SITE(LOP) CI HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> ❑ OTHER CLEANUP SITE(NON-LOP) ID FOOD FACILITY 4 90LID WASTE VEHICLE <br /> ❑ UNDERGROUND TANK(MONITORINGMEMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> O HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY ❑ MOTEL/HOTEL ❑ UMPER TRUCKI`(ARDICHEM TOILETS <br /> ❑ TATTOOIBODY PORCING ❑ POOL13PA V LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY t7 PUBLIC WATER SYSTEM O OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above. Select the type(S)of files from thv 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 /> -r 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 file that Is actively being worked on by EHD staff may not be immediately available for review. A now <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$89.00 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 /> REVIEVVED 1 YES NO REVIEW DATE <br />