Laserfiche WebLink
DATI;5Kr--',13 <br /> _ PJ16 Ld6 mums" <br /> SAN JO" UM COUNTYPUBLIC HEALTH SE, ICES <br /> �e;IRONMENTAL HEALTH Dl1I1S10 l 9 f3 <br /> 304 EAST WEBER AVENUE,THIRD VLDO cif <br /> MOCKTON CA 95202 <br /> (20)4%-3420 i 1 <br /> } PUBLIC RECORDS RELEASE APPL18ATION � <br /> APPLICANT utr <br /> ADIDRESS 1�� <br /> st. t.....- aUsINESSfAGEIVGYUtik�� oL.},Ji4�w511r�C, i <br /> a <br /> c� <br /> PHONE. I2L FACSIMILE f <br /> TLNTA7171VE0A PourrmF rvA-rE 2-` - 1,3[ trJE 1a <br /> (Pleaze atve'T to tta bysiness days from date of pGcistiort submittaq <br /> w <br /> CHECK 13OX TO CXAEDITI_RE43UEST•$78.00� FiEQUFST PR[]t;FSSEb Ai s BUS INPSMI BAYS <br /> SIGNATURE OF APPLICANT DATE -Zg <br /> FELL=ADORE <br /> 4 <br /> ? L G d <br /> L-D r <br /> N <br /> ;M <br /> R - <br /> ENVIRONMENTAL HEALTH pFVISION:FILESI <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) d Housif1G ApA��1Fa�1T', d SOt-1b WASTE FACILITY <br /> OTHFR CLEANUP SITE(NON.I_OP) 0 FOOD FACILfrY `� ❑ 301-113 WASTE VEHICLE <br /> vNDERGROUND TANK(MO"ITORINWRELIOVAL) Q DOG KENUEL r3 DAIRY <br /> HAZARDOUS WASTE CI"ERAT'OR 13 CHICKEN RANCH D PKC+TiMATMENT PL,UWT <br />{ G TIERFI)PERMITTEDFACfLITY ❑ NIOTi=LIHOTEL tb F] P# fIP R TRUC1V1rARD!{ fiE{�TOILETS <br /> TO <br /> 13 TATOIBODY PE]RGING M POOLMPA ' a L:AC'tp USE APPLICA-noPd SITES <br /> f33 MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM �� Ci 6THE t(PLEASE 8PEOPY ABUVE) <br /> 9. List tip to ten addresses in the space above. Seiect the type(s)of files from the list above by checking <br /> the appropriate box(es), At least one file type MUST be selecte{- Faxto d9) 464-0138 or a"l to the <br /> ad0i'ecs_1t%Qlcated above. t y <br /> z 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 rawlaw. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked or by EHD staff may not be iimmediately available for review. A new <br /> application may be submitted when the file Is available. <br /> 4. Any file not raturriad In the same roundition as released will be re orgy! lzed by EHD staff at the expense <br /> of the applicant Future file reviews by the same applicantmay;lreRusire a$78_DD deposit prior to review. <br /> S. 'TENTATIVE aPpointmont datoa mast he confirmed with EHD staff. ;I <br /> 6. Applications receTved after 3;00 pm will be processed the next bttsine`ss days. <br /> N <br /> .7 <br /> _ a <br /> • �� � � .�NV..I.r: _yu "5• _ ]E. v�:i.�r J �. Y� yr,. �iA:,•'' . <br /> '� TOTAL. P.02 <br />