Laserfiche WebLink
09/17/2003. 09:37 FAX 209 9480621 �J <br /> I r�, <br /> QQ4/QQ4 <br /> DATE RS ErV= <br /> SAN J 0 P ref Ery u��tl,� <br /> � r-ti��j �r, AQUIN COUNTYPUBLIC HEALTH SERVICES <br /> `� ,ji t �{1,: ENVIRONMENTAL.HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> S E P 1 7 2003 STOCKTON CA 0202 l <br /> (209)468-U2.0 <br /> _fv��iFtu€ MEflf HEAt_T . PUBLIC RECORDS RELEASE APPLICATION <br /> APp1,ICANr �. fr _BUSINESSIAGENCY .a f-�.1��2 <br /> ADDRESS <br /> PHONE Z A4 11 FACSIMILE_. 2O'q 0 b _1 <br /> TENTATIVE*APPOINTMENT DATE �r' L o _- TIME <br /> (Please give 7 to SQ husltsess days from date of appllcatlon submittal) <br /> I <br /> CHECK BOX TO ERPF-un-E REQUEST-$87.00 F QUEST P ESS ED IN 3 BUSINESS',DAYS , may, I <br /> -,r I <br /> SIGNATURE OF APPLICANT F.; DATE '5 ! �3 <br /> X� <br /> IIS <br /> FILE AODRE55 M PRo�IwuwtniE saRCH 1 <br /> d Z f}0LA <br /> ✓✓ 0 ted. ,NT Ltr14 t L <br /> 3 I� tir <br /> 31 Z N • wl4.�a►.� T' <br /> IId 7.�•I _ lk t ACJ�. lA t F <br /> ll t <br /> 3302 1% Lt a or �'- <br /> It"Jrr`.:r =' ./,_x;(,• ��� IfftL ��3��.,- 1-?din � is{�.4,�:�7=�� L�. <br /> ENVIRONMENTAL HEALTH DIVISION FILES`' <br /> 1A UNDERGROUND TANK(UST)CLEANUP Srl'E(Lop) n HouslNc ABATEM>=AIT Id SOLID WASTE FACILITY f <br /> OTHER CLEANUP SITE 1T1=(tlON-I.OP) 13 FOOD FACILITY � ❑ SOLID WASTE VEHICLE <br /> 9R UNDERGROUND TANK(MONrroRING/REmOVAL} ❑ DOG KENNEL DAIRY <br /> HAZARDOUS WASTE GENERATOR Q CHICKEN RANCH Ild PKG TfZF-ATMENT PLANT <br /> O TIERED PERMITTED FACILITY ❑ MOTELIHOTE- 0 PUMPER TRUCKlYARAICH&M TOILETS <br /> TAT'rADIBOnY PEIRCING ❑'POOUSI'A ' ' ' Rt LAND USE APPLICATION SITES <br /> El MEDICAL WASTE FACILITY C1 PUBLIC WATER SYSTEM O OTHER(PLEASE SPECIFY ABOVE) <br /> i <br /> 1. List up to tell addresses In the space above, Select the type(S)of files from the list above by checking <br /> the appropriate bou(es). At least one file type MUST be selected. Fax to(209)_454-0138 or mail taut e_ <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 afterr`eceipt of application. The files <br /> Will be held for a maximum of five business days for review. AppointrAents should be scheduled <br /> accordingly. <br /> 3. A fie 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 /> d. 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 iequire` a$87.00.deposit prior to revieW. <br /> 5. *TENTATIVE appointment states must be confirmed with EHD staff. <br /> 6. Applications received after 3;00 pm will be processed the next business day. <br /> - r <br /> CONFIRMED APPOINTMENT DATE TIMET <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE - <br />