Laserfiche WebLink
urug U111 N—kiU11I I <br /> f - 'IRONMENTAL HEALTH DEPART.-� NT <br /> id E Weber Ave P Floor Stockton, CA 9r26 <br /> APR 1 5 Z(q�)468-3420 Fax: (209)464-0138 Web:www.co.sin-joaquin.caus/ehd <br /> h'I'rALTH PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: g&c; ae-ryf- BUSINESS/AGENCY: <br /> &WiVOMZ <br /> ADDRESS: 51,P7e&,M s-&T/ <br /> P"_L Liv-e, ft-'W-e <br /> PHONE: FACSIMILE: -6(20< <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of appik'ation submittal) <br /> ;t I <br /> V/ct,VCK BOX TO EXPEDITE REQUEST-$93.00 FEE RE( ESTPROCESSEDIN3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT f I <br /> DATE <br /> Devadmnt Use Only <br /> FILE ADDRESS UNIT <br /> AJI — <br /> 2. ,suet &a [I Unit 1 <br /> 11�2 A <br /> 2�fl ti� (q-0 <br /> L4QV I U n1ro Unit 2 <br /> L�i4Ae styes City 5tee4j,�,- <br /> AIM- Cit, <br /> —2 <br /> 6. Unit 3 <br /> �2 <br /> bdu-�. CRY �,bLj� 151 V i <br /> 7. S" e- <br /> e� -45 <br /> 2 �/ Unit 4 <br /> 9. sa _26,�' tf, 2!X 3WVMA ,, D Unit 5 <br /> City <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(Lop) 13 HOUSING ABATEMENT 0 SOLID WASTE FAC'Ikr?!� 1®R <br /> OTHER CLEANUP SITE(NON-Lop) 0 FOOD FACILITY 13 SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONTTORINGIREMOVAL) 0 DOG KENNEL 0 DAIRY <br /> HAZARDOUS WASTE GENERATOR 13 CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> TIERED PERMITTED FACILITY 0 MOTELIHOTEL f E3 PUMPER TRUCKfYARDICHEM TOILETS <br /> t3 TATTOOMODY PIERCING 0 POOLJSPA4 0 LAND USE APPLICATION SITES <br /> 13 MEDICAL WASTE FACILITY 13 OTHER(PLEASE SPECIFY) <br /> 1. i <br /> 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)464-0138 or mail to the <br /> address Indicated above. 1� <br /> 2. EHD Will notify applicant If any EHD files exist An appointment for review will be con I firmed <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. . 1 <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. ;j <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$93.00 deposit prior to review. <br /> S. *TENTATIVE appointment dates must be confirmed with EHD <br /> D staff. <br /> 6. Applications received after 3:00 pm will be processed the next business daf5—'), <br /> CONFJRMED NTMENTbATE. <br /> TIME <br /> DATE-CONFIRMED. <br /> ':�..'�'`.PHONE FAX _,.,:..--1NITIA1 P <br /> REVIEWED YES NO REVIEW 1 DATE <br /> EHD"424" <br />