Laserfiche WebLink
Wo��_46PM -"�iI 0• Anderson & Assoc• No .422S t�P . 2't�it:�t:.�ti SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> FEB 17 2004 - 304 E Weber Ave 3`a Floor Stockton, CA 95205 � <br /> ENVIRONMENT Rjf A68-3420 Fax: (209) 464-0138 Web: www.co.san-joaquin.ca.us/ehd �I <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: `' +`'eN.GI-D BUSINESSIAGENCY:- f 9 • 0 - �e,,v s <br /> ADDRESS: 02us�aj 9 <br /> PHONE: 15t.12-4 <br /> FACSIMILE: 3(Q9 ` L}Z2 g <br /> TENTATIVE"APPOINTMENT DATE: <br /> �j �'• Q� Time: -1�•� 0.Nn <br /> (Please allow 10 business days from date of application submittal) <br /> CHECK BOX To EXPEDITE REQUEST-123.00 FE -REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT <br /> DATE <br /> DeDartment Use Only <br /> UNrr , <br /> FILE ADDRESS <br /> rl. .$ 3 3 W• �rti2 Sk. ' ❑ Unit t <br /> 2 30S4r;.� 3 ❑ Unit 22 Z3 W• Wok e;. tree <br /> can G �; oZ � 5� a <br /> 01R avI PO Unit 3 i <br /> S. street ` <br /> s. suet, ^d �'k Ch <br /> t O ' <br /> 7- scree= 7 ec�• ,�yl�� C C3 i 1run t�nit4 <br /> 9. street 33 G• I i - s Cil , V •` a <br /> 4. Scree, 3-11 �. ►Mtol_:,,n 5A , ✓ ._ � cvN unit <br /> to. street 304 C-A C.)a- �eckj <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK US CLEANUP SITE(LOP) 0 HOUSING ABATEMENT 0 SOLID WASTE FACILITY <br /> 1A ( <br /> � OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY 0 SOLID WASTE VEHICLE <br /> P& UNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL ❑ DAIRY <br /> It HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY 0 MOTEUHOTEL 0 PUMPER TRUCKIYARDICHEM TOILET: <br /> 0 TATTOOIBODY PIERCING 0 POOLISPA ❑ LAND USE APPLICATION SITES <br /> 13 MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) - <br /> 1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checkii <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 file <br /> wilt 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 r I <br /> application may be submitted when the fife is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expel <br /> of the applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to rev <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 /> I <br /> EMO 4a-02406 <br /> S;'8r2a03 <br /> l <br />