Laserfiche WebLink
TO 102WMSSS P.01 <br /> JUL 2 fi 2a4� SAN JOAQUIN CQUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> E VIRONMES�T HEA�T� 3"EAST WEBER AVENUE,THIRD FLOOR <br /> PERMITISERVICES STOCKTON'CA 95202 <br /> (209)488.3420 <br /> PUBLIC RECORDS RELEASE APPLICATION f�{ <br /> APP[..ICANT nn f VE 1 SSrOAaGEI�V7GIyC �(� "1 `� � 7�� r'"r- - may <br /> A>}01M.9S W lk V 1 Y4 Y �✓i ii. _ ?L l I *r� Q` �'T <br /> PHONE qa[i <br /> TENTATiYEw APP0WTLa6?T IMATE -- _-- TIME �-- <br /> (P[aase give 7 to 10 b=na=days tram date of apK=Uon submittal] <br /> CHECK BOX TO EXp=yF REQUFXT-$r&00FEE-REQUEST PRuCESS€D IN 3 IWSINZW DAYS <br /> SIGNATURE OF APPLICANT DATEQIdU A &7) <br /> F1]„2w ADDRESS ?x[Z SJDE J.K0 STAFF E an[L.Y <br /> PROGRAM EI_F_mr&i M SF-&RCH <br /> 2Z �- IV1 <br /> too 3 moo[�Ta <br /> ENviRON MENT•41. ki- AL.TH DIVISION FILES <br /> umDrRr.ROuNa TANK NST}MEMUP SITE(LOP) ❑ HOMINl0 ASATEMENT 4 SCUD WASTE FAClL1TY <br /> C QTHE$CLEANUP WM(N0K4-0M ❑ FOOD FACILRY 0 SOLID W!1_.TM VEHICLE <br /> O UND211GROUND TANK(file ONITC?R UGntEMOVAL) a DOG KENNET. 0 DAUCY <br /> *K ZA&DOUS WASTE GENERATOR Q CHICIMN PlAt CH 0 pKG TREAWEHT PLANT <br /> 0 TIERED PE"rMD FACILITY a N[C}MUNOTEL ❑ PUMPER nWCXJ)rAP"CHEM TOUXTS <br /> CI TA7TOQIfBC3DY PEtRCIIdG <br /> 0 POMA A C[ LARD USE APPL[srAT10H SnLS <br /> 0 ME131cAL WASTE FACIUT`f C3 P13BLM WA'iER SYSTEM 0 OTHER(PL.CCASE 5F*QFY AaQVE) <br /> 1. List up to ton addrassas In the space above. Select the type(a) of files from trio iEst above by checking <br /> the appro"te box(es). At le2st one file 4%e MUST be selecte& Fax to(MO)46"135 or mall to the <br /> Ic <br /> 2. END will notify the appiicant It my EKD files exist An appointment for revWw will be confirrhed <br /> appmx8rnatW five business dos but no later than ten(10)days after receipt of appacation. The files <br /> will be heid for a nuWmum of fve business days for review. Appointments should be embeduled <br /> accordlrsgly. <br /> 3` A fils that Is actively being wonted on by EHD staN may not be immedist4dy available for rav w. Anew <br /> application may be submitted when the file is avallat". ;e <br /> 4_ Any fila not returned In the same condition as reloaaW will be reorganized by F± 10 staff at the anpensa <br /> of tho applicant. Future file reviews by the Sams applicant may require a$75,00 deposit prior t*review. <br /> OTENTATIv appointmmt datesa flmsa M be opnfirr*d with EMG*Wf. <br /> 6- AppllcaWns received Otar 5:00 pm will be proceusad the next lousiness day. ' <br /> CONFIRMED APPOINTMENT DATE __ TIME <br /> _ �-- ---„ <br /> TATE CONFIRMED PRONE FAX INITIALS <br /> REVIEWED YES No REVIEW DATE <br /> QH 40 <br /> 1VTFL P.at <br />