Laserfiche WebLink
OAII-RCCLIVLO Ck Illd YQ:.tti pit 1,�- I1 <br /> SAN .:,�,,.QUIN COUNTYPUBLIC HEALTH S!~�CES l� �l=-ail <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR ;0JAN 0 2 2001 <br /> STOCKTON CA 95202 �' <br /> (209) 468-3420 NVIROidiv;EfV(HEftiLTH <br /> PUBLIC RECORDS RELEASE APPLICATION PERMIT'SERV10ES <br /> APPLICANT \� ,a `1 � `C �?/` BUSINESSfAGENCY �V 1`nyY '_ e < � <br /> ADDRESS- -loo k Ux-\\q eufs1 �V�.��A _ C] -- 1 C Pt 9159a5 -- <br /> PHONE +-t ``f��}O FACSIMILE_(q U01 '_a�(04 -4501..- _ <br /> TENTATIVE"APPOINTMENT DATE 0^k' Y!� �Q) �1 TIME 1.50 A� <br /> (Please give 7 to 10 business da)s from date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$87.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE t <br /> ^T FILE ADDRESS THIS SIDE END STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> VA). c -+scam+ % . ray(- PP1-1-e ! 3.Sak 4k - — <br /> ------ - ------- <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE f'ACILITY <br /> C3 OTHERCLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> ❑ HAZARDOUS WASTE GENERATOR Q CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> Cl TIERED PERMITTED FACILITY ❑ MOTELIHOTL-L ❑ PUMPER TRUCKlYARDICHEM TOILET-S <br /> n TATTOOmODY PEIRCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEOICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER{PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses In the space above. Select the type(s)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the <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 after receipt of application. The files <br /> will be held 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 avalIabie. <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$87-00 deposit prior to review. <br /> 5. "TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> —fah UD 14 DM7tUO —" — ---- <br />