Laserfiche WebLink
Au • 20 . 2003 1 : 20PM , CONDOR EARTH TECHNOLOGIEG No 4148 r . I/I <br /> Dn7H AECE�VED END LOG NUM6CH <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> A J r P cOLU 304 EAST WEBER AVENUE, THIRD FLOOR I <br /> STOCX70N CA 95202 <br /> (209) 468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT p-- � <br /> Fa; !a G44n ` . -1r1 HU5INE(SS�/AGENCY <br /> ADDRESS �'O C.J F�' i <br /> PHONE �� ?f�] /FACSIMILE �Ft• r' ;1�7L7 <br /> TENTATIVE'APPOINTMENT DATE q UQ TIME , w <br /> (Plaase give 7 to to business d from date of application submHtal)� to <br /> `7 <br /> • <br /> CHECK BOX TO EXPEDITE REQUEST•$87 CO FEE REQUEST PROCESSED IN 3 BUSINESS DAYS ' W-j,U?5 , <br /> SIGNATUREOFAPPLICANT < DATE <br /> c <br /> FILE ADDRESS THIS SIDE END STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH - <br /> AIN D filL.{YJY� 07 <br /> r� <br /> GD <br /> f, <br /> -r <br /> Aye . <br /> ' l ENVIRONMENTAL HEALTH DIVISION FILES <br /> ' f UNDERGROUND TANK(UST) CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGMEMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH la PKG TREATMENT PLANT <br /> TIERED PERMUTED FACILITY ❑ MOTELIHOTEL ❑ PUMPERTRUCKIYARD/CHEMTOILETS <br /> ••' TATTOO/BODYPEIRCING ❑ POOLISPA 0 LAND USE APPLICATIONSRES <br /> MEDICAL WASTE FACILITY PUBLIC <br /> ��WATER <br /> 'Sn IYS M O OTHER(PLEASESPECIFYA60VE) <br /> 1. <br /> List up to ten addresses in the space above.'Sele 4_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)464-0138 or mail to 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 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 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 /> 5. 'TENTATIVE appointment dates must be-confirmed with EHD staff. 41q, <br /> ,�. <br /> 6. Applications received after 3:00 pm will be processed the next business day. f' <br /> CONFIRMED APPOINTMENT DATE TIME <br />