Laserfiche WebLink
TO • (35B1@0a P.01 <br /> d SAN JOAQUIN CO UNTYPUBLIC HEALTH SERVICES WµU <br /> EgVIRONMENTAL HEALTH DIVISION <br /> 3q4 EAST WESER AVENUE,TH1RC)FLOOR / <br /> sTOCKTON CA 95202 <br /> (209) 4$8-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> 1APOLICANr <br /> AQ\ti.,E�.yt�� <br /> P-IpNE �a22 - - - »n ' FACSIMILE <br /> e6zx X-I\'2. <br /> 7ENTATIV E"AppolNTMeNr pi}TE. nMs <br /> (Pleoan ei>te 7,tv 10 businoss arr dal¢or pllcaclon submittal) <br /> LI�v�TS , <br /> CHECK 80x TO EXPEDITE REQUEST A0 ,�E6.�-R_8QVE$TPROCESSeA iN3BUsINES50AYS <br /> -SIGNATURE OF APPLICANT uxy ? p�i� DATE t 1 1 200\ <br /> FlLB AOOResS THIS 1DFEHDSTAFFUSE.ONL1r <br /> PROGRAM ELUMENTe SEARCH <br /> 2 `3 Toro .S3 3s-7 -?S.sO <br /> t.ap,� baav�. -ec�or.� ay.Go <br /> 1 7 t.M1OPzV SI c tom: rE9 -o9+v a <br /> at�.6R c -C k tVc1r Cep AkW <br /> tvc�e I N C�u \ 3S a z A'/c <br /> E14VIRONMFNTAL HEALTH DIVISION FILES <br /> UNUCKGROUNO TANK(UST)CLEANUP 9t7E(LOP) ❑ HOUSING ABATEMENT 0 SOLID WASTE FACIUrY <br /> 4THFR CLEANUP SITE 1NON LOP) I O FOOD FACILITY 0 SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MQWFOR)NG(REMbVAL) ❑ DOG KENNEL a DAIRY <br /> 0 HAZARDOUS WASTE GETIERATOK Cl CHICKEN RANCH 17 PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED?AGILITY LI MOTEL/HOTPL Q PUMPER TRUCK)YAROfCHEM T0111�T5 <br /> L7 MEDICA WAST9 1RC;iU ❑ POOtr$PA ' ' ❑ LAND USP APPLICATION SITES <br /> ❑ MEDICAL WASTlt FACIU7l' O PUBLIC WATER SYSTCM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten.addresses In the space above. Select th'e type(a)of files from the fist above by eher.<ing <br /> the appropriate BOX(es). At least one file type MUST be selected. Pax to(Z29144 " ' .0134 or mail to I he <br /> apdrpsS inoicated abovo -Lie <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 tan(10)days after receipt of application. The fires <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that ls.ietively being worked on by EHD staff may not be immediately available for review. A naw <br /> applicatigfl may be submitte4 when the file is available. <br /> 4. Anyfile not returned in the same condition as released will be reorgani <br /> of the appliczed by EHD stall at the oxpen e <br /> ant. Future bile reviews by the same applicant may require a $417.00 depo.ylt prior to re%iew. <br /> s. `TENTATIVE appointment dates must be confirmed with EHD staff. <br /> fi. Applications received after 3:00 pm will be processed the next business day. <br /> NFIRMED APPOINTMENTRATE TIME <br /> 'ONFIRMED PHONE FAX INITIALS <br /> > YES NO REVIEW DATE ' <br /> TOTAL P.©1 <br />