Laserfiche WebLink
WIN COUN`fYPUBLiC HEALTH ; 'VICES <br /> 1VIRONMENTAL HEALTH DIVISIO - 0 9 <br /> 304 EAST WEBER AVENUE,THIRD FLOOR ) <br /> STOCKTON CA 95202L�r <br /> (209)468-3420I. , (. <br /> PUBLIC RECORDS RELEASE AEPLICAT10 A <br /> APPLICANT �ItfSWESSIQGElJCY t'�tI!jy A <br /> At3DFtE55 <br /> d S-" LL�I iso ., ?�. <br /> r. PHONE t `IL/ FACSIMILE <br /> ' I <br /> TENTATIVE"APPOINTMENT DATE _ . _ TIME <br /> (Pfease give 7 to 10 business days from'date atappiication submittal) <br /> CHECK 9OX TO EXPEDITE RLQU T-578.00 FEE—11120U S PROCESSED IN 3 BUSINESS DAYS <br /> i! <br /> SIGNATURE OF APPI_ICAN DATE <br /> FILE ADDRESS' i <br /> ,ir <br /> 4 <br /> 1 nC0S tfur <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT 0 SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON,LOP) o FOOD FACILITY 0 SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) M DQU?FENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR LJ CHICKEN RANCH M PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTEQI40T;L O PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑ TAT'T00113ODY PEIRCING 0 POOLJSPA' ❑ LAND USE APPE_IGATICIN SITES <br /> 0 MEDICAL WASTE FACILITY 0 PU13L1C WATER SYSTEM Q OTHER(PLEASE SPECIFY ABOVE) <br /> 7_ 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 ML18T:''be selected. Fax to 209 464�-0.138_or mail to the <br /> address indicated above. <br /> 2_ EHD will notify the applicant if any EHD files exist. An appointment for revlow 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 avallable. t <br /> 4_ Arty 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 $78.00 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 /> i <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED. PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE _ <br /> CH Oo a ovoseao <br /> r�t <br /> 12- 1 TOO <br />