Laserfiche WebLink
P. 1 <br /> 8_09_2082 9:54AM FROM SITE ENVIRONMENTAL 2094728654 j62 <br /> u r o iw t riL U]:/.b Ob4VIJ8 ENVIRONMENTAL HEALTH <br /> DASR AGCENLD <br /> SAN JOAQUIN'COUNTYPUBUC HEALTH SERVIC <br /> y ENVIRONMENTAL HEALTH DIVISION i R& <br /> r` l 304 EAST WEBER AVENUE,THIRD FLOOR AUG 0 9 2002 <br /> STOCKTON CA 95242 <br /> 3 (209).488-3420 VIRUNMENT HEALTH <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> 13usj ==AGE icer <br /> APPS.tCAP[T <br /> AotJrtEss (ole 5.3 • �_r r cn 4 Dr <br /> PliONE loot 2 S'(aSD --- - FAMMILE^ )q 7 <br /> TENTATIVE*APPOINTMENT DATE TIME - <br /> (PteaSe glv &tiolO mess days from of appt tion submittal <br /> CHECK BOX TO FXFMrrE REQUEST- <br /> ' UE RpC IN USINEss DAYS <br /> A — DATE <br /> SIGNATURE OF APPLICANT d <br /> FILE ADDRESS tYE1S SLOE$HD STAFF USE pNtY <br /> / PRdGRAh1 ELt^7MEA1TS SEARCH <br /> V <br /> C" <br /> Atli __2141 <br /> ENVIRONMENTAL HEALTH DMSION-FILES <br /> ❑•HOUSIIiG AF3ATEMENT' to SOLID WASTF FACILITY <br /> X UNDERGROUNO TANK(UST)CLFANuP$ITE(LOP) ❑ FOOD NG B AT E3 SOLID wAM vEHICLJt <br /> TY <br /> OTHER CLEANUP SITE(Moil-LOP) ❑ DOG KENNY 0 DAIRY <br /> UNDERGROUND TANK(MON11.0 01pEMOVAL) O CH1CkEN RANCH O PKG TREATMENT PLANT <br /> ffi NAZAWMS WASTE GEMRATOR G MOrEJ.RWTEL In PumPER TRucKryARvicHEM'rOm Ts <br /> 6"T'FERED PERMnr rFD FACILITY d POOt1SPA G LAND USE APPL.ICAT1014 STM <br /> ATTQO�eflDY PEIftCtNG Q OTHER CPLEASE SPECIFY ABOVE) <br /> O T <br /> ❑ TTOO/DICAL WASTEFACILITY ❑ PUSUC WATER SYsTem <br /> 0, List up to ten addresses in the space above. Select the type(s)of f)les from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. <br /> d64-0'f38 or mail to the <br /> _ address inficaled ati'ove• appointment for review will be confirmed <br /> Z• E}d will no the applicant it any EHD files exist_ An apps <br /> approximately five btiziness days but no later than ten(10)days after reCBipt of application. The tilts <br /> will be held for a maximum of five business days for review. appointments should be scnteduled <br /> accordingly. <br /> A fIt'i that is actively being Worked on by EHU staff may not be immediately ayaiiabie for review, new <br /> g. <br /> A file atlon may be submitted when the file is available. staff at the expense <br /> a, Any file not returned in the same condition as released antmay require a$89.00 de'd by eposit t prior to review• <br /> of the applicant. Future flit reviews by the same app <br /> 5- "TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received atter 3:00 pm will be processed the next business day. <br /> TIME <br /> CONFIRMED APPOINTMENT DATE. <br /> OATS CONFIRMED <br /> PHONE FAX INITIALS r� <br /> FtEV1EW QATE <br /> REVIEWED YES NO <br />