Laserfiche WebLink
07/11/2003 13: 47 2094671" R AGE STOCKTON PAGE 01/01 <br /> DATE RECEIYEp 1 EMU X00 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 11,11,_ 1 1 0 0 J 304 EAST WEBER AVENUE, THIRD FLOOR h <br /> STOCKTON CA 95202 <br /> ii 9i s'•,'; , L1 F1 (209)468-3420 `^ <br /> I PUBLIC RECORDS RELEASE APPLICATION <br /> �10 SUSINESSIAGENCYAPPLICANT n <br /> ADDRESS C S J1 cle-lo1V �ua}�sSQa � �C1UlYY]Y1�1�1 1L Q <br /> sw l ` <br /> PHONE RQ ' . ^� l_ ILOIDt FACSIMILE � t 4 [ I //�� <br /> TENTATIVE''APPOINTMENT DATE- JUj <br /> [ U4 ��� TIME •'6)�/ inlet <br /> (Please give 7 to 10 businasgf days from data of application submittal) <br /> CHECK BOX TO EXPEDITE RE:;;Z <br /> $89.00 FEEEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> / l S <br /> %1'e , k 1) <br /> W • IPP-n rA L._ ST <br /> / a I VW LL <br /> _ <br /> r1 <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTEUHOTEL ❑ PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑ TATTOO/BODY PEIRCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ 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 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 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. Future file reviews by the same applicant may require a $89.00 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 RLI <br /> REVIEWED YES NO REVIEW DATE <br /> PHO 4e-02-008 <br /> 3/208003 - <br />