Laserfiche WebLink
�-21-2004 13:38 FROM-COLLIERS I' +2094765102 T-469 P1W/H2 F-473 <br /> GATE Rc'CEIVED SAN JOAQUIN COUNTY <br /> EN 4 F Wtb F N vc 3 HEALTS DEPARTMENT 2 <br /> 304 F Webs Ave 3"d FIoDz Stockton, GA 95205 <br /> (209)468-3420 Fax: (209)464-0138 Web:Www.CO.san joaquin-ca.us/ehd <br /> rU-jaLIC RECORDS RELEASE APPrLICATI�ONN <br /> APPLICANT: <br /> ADDRESS: <br /> b7 <br /> FACS <br /> NONE: IMILE: <br /> TENTATNE'APPOR"CWTDATE' Tim•=—~ �' <br /> (Please allow to puslness days Ran Oats of 8011140n submltml) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST EE•-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> DATE �4✓ <br /> SIGNATURE OF APPLICANT Departnont Usa OniY <br /> Oho 03 pcJ�k d� SfxC l <br /> UNIT <br /> FILEADDRESS /. <br /> s v5` S(d C3 Unit <br /> � ❑ Unit <br /> 1 Sbm Q Ay�/I <br /> � a Sam OIL "o <br /> S. �l <br /> e nit 4 <br /> s p Unit s <br /> G„ �z N <br /> uRI <br /> ENVIRONMENTAL HEALTH DEPARTMENT FR-/ES <br /> C($OLID WASTE FACILITY <br /> }NipERGE20UND TANK RJST)CLEANUP ST7'E(tAPI D F06 FD pCll.liY ENT r7 SOUP WASTE VEHICLE <br /> til OTHER CLE/WUPS p ITE(NPN-{.OP) DOG�� In DAIR7 <br /> C(J INDERGROUNDTANK(MONITORIJGIMMOVAI.) 0 LIMN BCH In p TMENT PLANT <br /> IMAZARDOUS WASTE GENEP.ATOR O MOTELAIOTELr r3 t! pLniaPERE[2 TitUCK/YARDIGttEM TOILETS <br /> TIERED PEMAMED FACTL" pPA C LAND USE APPLICATION 5n"ES <br /> ❑ TATTOOIBODY PIERCING 4�ERMY-ASE SP <br /> 17 MET7ICAL W AST£FACII-nY <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 be es). At least one file We MUST be selected. Fax to 209)4s4A1$8 or mail to the <br /> address Indicated above_ review <br /> Am 2. FHO will <br /> matery fthe ive business days but ritif any po latefilesr th n ten(1R)days after rrece)pt of alpPtlFauan The Tiles <br /> will be hold for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 2. A fite that is actively being worked on by EHD staff may not be Immediately available for review. no, <br /> application may be submitted when the file Is available. reorganized by EHD staff at the experts <br /> 4. Any file not returned in the same condition as released will be <br /> Of the applicant. Future file reviews by the same applicant may require a b no deposit prior to revie <br /> S. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Appilcatlans received after 3:00 pm will be processed the next business day <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE:CONFIRMED PHONE . FAX dVfT1A1.5 <br /> REVIEWED YES NQ REVIEW DAM <br /> veaoo� 9-QR-0U. GIST rv,c '40 PA-ant%'/'L,f.t'J4 <br />