Laserfiche WebLink
o' MODESTO ATC PAGE 02 <br /> 11/10/2000 12:42 209-57_ 5 NOP' 57922-25 P.e: <br /> X00 LFRO - <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> OO ENVIRONMENTAL HEALTH DIVISION <br /> NOVZ O ZO THIRD FLOOR <br /> 304 EAST WEBER AVENUE, >• <br /> STOCKTON CA 0202 <br /> ENVIRONMENT HEAL" <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> « 4ti 6USINESS/AGPNCYAlp <br /> __L�1 <br /> `T" 25 Sof <br /> Zp3ct '-moi Z"l Ll <br /> c, 'j•-,2"Z l - FACSIMILE <br /> TIME <br /> t«• svbmitta <br /> N lVE A?POtNTh1tNT DATE <br /> ,ay <br /> ISO"give 7 to 10 business days front 431e of avPapplicationp <br /> 15Z/,4CHECK SOX TO EXPEDITE REQUEST.1711.00 EE -REQUEST P OCgSSED IN 3 BUSINESS DAY$ <br /> �. BATE <br /> SIGNATURE OF APPLICANT <br /> FILE ADDREss <br /> -3 �. �1,� /til..t, _ <br /> I I �-i'� s.. Y►\.+ 81 +�ay e dy Sc f, S 4n Ir:}amt _ - 35_,� <br /> '— 4l W. L Jl�✓ tom, <br /> ln1 a S l K Fo-\ <br /> (A VA-kr <br /> St,rwc.F_•.,_.. <br /> ,rt t <br /> tS � e r+ cl..>a.� W� 5 ti4,o-, .3.5•zV 2 <br /> ill• C._, ,r r W �c.t�- ���:�,� �.��- .. <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(t OP) C HOUSING ADAYEMENT a SOLID WASTE FACILITY <br /> lx OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY M 50L10 WA3TE VEHICLE <br /> C3 UNDERGROUND TANK(MONITOPLNGIREMOVAL) d DOG KENNEL O DAIRY <br /> O HAZARDOUS WASTE OrNERATOR a CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY 0 MOTEUHOTEL O PUMPER TRUCKFYARD1CIiEM TOILETS <br /> 0 TATTOaaOpY pE1RCING 0 POCL13PA O LAND U3E AFPucATION SITES <br /> C1 MEDICAL WASTE FACILITY C PUELUC WATER SYSTEM t7 OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to tan addresses In the space above. Select the type(a) of files from the list above by checking <br /> tho appropriate box(es). At least one file type MUST be selected. Fax to(2g21454-0138 or mail to the <br /> address Indicated;iboviL <br /> 2. EHO will notify the applicant it 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 hold 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 $78.00 deposit prior to review. <br /> 5. "TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 61 Applications received after 3:00 pm will be processed the next business day. <br /> 1 <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> <h D� � OtAS,OG <br /> TOTAL P.22 <br />