Laserfiche WebLink
f <br /> J61/07/29(32 16:07 269467 ' 3 AGE S1OCKTU,a <br /> �- /ELATE RrCEIYED ,,..LOG NUMBER <br /> .1•/ SAN JOAQUIN COUNTYPURLIC HEALTH S .!ICES <br /> Ir ENVIRONMENTAL HEALTH DIVISION <br /> L1 L 304 EAST WEBER AVENUE,THIRD FLOOR <br /> 1 STOCKTON CA 95242 <br /> - (249) 468-3420 <br /> r PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT ESSIAGENCY I <br /> ADDRESS ��yy <br /> PHONE 2V d FACSIMILE <br /> TENTATIVE*APPOINTMENT HATETIME �SS_ <br /> (Please give 7 to 10 business days!r m date of application submittal) <br /> 6e.vl%S <br /> CHECK BOX TO EXPEDrrE REQU ST-578.00 FE1=-RE4UE T ROCES kEED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> i <br /> FILE ADDRESS <br /> 3.S <br /> � 3S <br /> a tr <br /> - I <br /> ' I <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(EAP) O HOUSING ABATEMENT ❑ SOL-ID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGlREMOVAL) C1 DOG KENNEL © DAIRY <br /> ❑ CHICKEN RANCH ❑ PLCO TREATMENT PLANT <br /> HAZARDOUS WASTE GENERATOR p CHICKMOTEN RANTEL ❑ PUMPER TRUCKIYARDICHEM•TOILErS <br /> TIERED PERMITTED FACILn'Y 0 POOLISPA L © LAND USE APPLICATION SITES <br /> ElTATTOOIBODY PEIRCING a PU>3L1C WATER SYSTEM) © OTHER(PLEASE SPECIFY ABOVE) <br /> ❑ MEDICAL WASTE FACILITY <br /> �. List tip to ten addresses in the space above. Select the types) 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 ail to th <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 five business days for review. Appointments should he scheduled les <br /> will be held for a maximum a <br /> accordingly. <br /> 3. A file that is actively being-Worked on by EHD staff may not be immediately available for review. Anew <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. f=uture file reviews'by the same applicant may require a $78.00 deposit prior to review. <br /> g. *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 PATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> I` REVIEW DATE <br /> REVIEWED YES NO <br /> EH 00 44 01/05100 <br />