Laserfiche WebLink
FROM : Geo-Phase Environmentai C. FAX NO. 2095690295 Sep. 18 2003 03:22PM P2 <br /> DATE RECEIVED, -- EHD LOG NUMBER <br /> lDl ;t' �� j�,j� SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT O <br /> SEP 18 2003 304 E Weber Ave 3rd Floor Stockton, CA 95205 <br /> (209)468-3420 Fax: (209)464-0138 Web:www.co.san-joaquin.ca.us/ehd ��J/ <br /> ENVIRONMENT HEALTH <br /> PFRMITISERVICES PUBLIC/RECORDS RELEASE APPLICATION <br /> APPLICANT:, I�ijal�P_ BUSINESS/AGENCY:���&�Otb C. ,✓z vis fV s-f/ 7V <br /> ADDRESS: 3 e2/ 7 /14 ni 9 4M4!X ,. e— <br /> PHONE: 15"6 ! 41A23 FACSIMILE: <br /> ^ <br /> TENTATIVE'APPOINTMENT DATE: �e� 7 Time: A�l _._, <br /> XCHECK <br /> S(Please allow 10 business days from date of application submittal) <br /> BOX TO EXPEDITE REQUEST- 3.00 FEE-REQUEST PROCESSED IN 3 BUSINESS PAYS 37 <br /> SIGNATURE OF APPLICANT DATE <br /> Department Use Only <br /> ..� FILE ADDRESS UNIT <br /> str n <br /> c4o,kcr V, aly <br /> El Unit 1 <br /> at, <br /> a sveet /// ct 2.Q7 (�❑ Unit 2 <br /> 4. sweat CI G <br /> s_ Street Cn Unit 3 - .�GL3•� <br /> e. Street City <br /> r. Sven CI Unit 4 <br /> e. 6,ree, dl <br /> 9. St., �'t t)nit fi <br /> ,9. suem G <br /> / ENVIRONMENTAL HEALTH DEPARTMENT FILESy�ry� <br /> R�.�1/�)NDERGROUND TANK(UST)CLEANUP SITE(LOP) 13 HOUSING ABATEMENT ❑ SOLID WAS FRCILfTT <br /> UJ� THER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> NDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> ❑ HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPERTRUCKlYARD/CHEM TOILETS <br /> ❑ TATTOOIBODY PIERCING ❑ 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$93.00 deposit prior to review. <br /> S. '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 /> e11D 9440496 <br /> VYi001 ' <br />