Laserfiche WebLink
.IUN-1Y-2005 16:19 CONDOR EARTH TECH 209 532 0773 P.02 <br /> JA1VJVAt1um, %,VU1V1Y <br /> W 115 ,J LSONwNTAL HEALTu DErauMENT <br /> 304E Weber Ave P Floor Stockton, CA. <br /> v�lv 2 U 1p�99)46&3424 Fax: (209)464-0138 Web:www.Co.san-joaquinca.us/ehd.ca,us/ehd �GU(xJ <br /> i-14VIRONMENT HEALTH pUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: PAT-�9G6 )7a c7 BUSINESSIAGENCY; C.71\fTZtfZ � ru ��lJ-i _ <br /> ADDRESS; 0�1 /o/a� �2JRlJ L.AN6 <br /> PHONE:_ 0361 FACSIMILE: nn0`209• .l <br /> TENTATIVE•APPOINTMENT DATE: LTime: . 4 AM <br /> (Plans allow 10 busirim days from A of applloadon submittal) <br /> 13 CHECK BOX TO EXPEDITE REQUEST-$93.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Department Use Only <br /> FILE ADDRESS UNIT <br /> SneeI a <br /> 01 <br /> 2. Sum 3 a ❑ Unit 1 <br /> a. sva to a nit2 <br /> o, s a <br /> ON <br /> a. svae� 94 S. a L Unit 3 <br /> 7. ft� 51 City �Unit 4 h <br /> e. so-ae� 710 5 -ci, <br /> ❑ Unit <br /> io. svaet 9 4 5 . oc1U-On <br /> it <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES oset <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT SOLID WASTE FACILITY <br /> OTHER CLEANUP SfTE(NON-LOP) O FOOD FACILITY �, SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL V/DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> L3 TIERED PERMITTED FACILITY ❑ MOTEUHOTEL 0 PUMPERTRUCKrrARofcHEMTOILETS <br /> C7 TATTOOIBODY PIERCING 0 POOLISPA la-UWD USE APPLICATION SITES <br /> Ag' 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 /> 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' <br /> REVIEWED YES NO REVIEW DATE <br /> � "42-0 6 <br /> emnoaa ' <br /> TOTAL P.02 <br />