Laserfiche WebLink
03/25/2004 7.7:49 . 4159899934 ENVSF PAGE 01 <br /> SAN JOAQUIN COUNTY <br /> MAR 2 6 2004 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave 3'Floor Stockton, CA 95.205 q7 <br /> F[WiRONMEPJT H400468-3420 Fax: (209)464-0138 Web: www.co.sala joaquin.cams/ebd 7 <br /> PERMIT/SERVICES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: N BUSINESSljGEN']C�Y-�: /(/ CJ z <br /> ADDRESS: rOI r'' ✓!/"y JCO <br /> PHONE: S _. FACSIMILE <br /> TENTATIVE`APPUIN I'MLN I VA I It: ri � Time, <br /> (Please allow 10 business days.from date of application subr"Ittal) <br /> CHECK BOX TO EXPEDITE REQUEST-;9 .04 FEE—REQUE=ST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANTs/�/ DATE �T <br /> epartmerd:U3e Only <br /> FILE ADDRESS UNIT <br /> - <br /> 3. D ill 50,u Ah ON <br /> ! Unit Z <br /> 6. 'i at <br /> C <br /> +r Unit 3 <br /> r. atL4 rn Vi doea <br /> c Unfit <br /> 1 -h! G r` AJ# S ❑ Unit5 j <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ASATEM�NT. ❑ SOLID WASTE FACILITY <br /> ❑ OTHEfZ CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> 27-UNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL ❑ DAIRY <br /> ❑ HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> 4 TIERED PERMITTED FACILITY ❑ MOTELlHOTEL O PUMPER TRUCWYARDICHEM TOILETS <br /> G TATTOoraODY PIERCING M POOL10PA M LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> i. List up to ten addresses in the spacf-above. Select the type(S)of files from the fist above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to('209146479738 or rnai(to the <br /> address Indicated above. <br /> 2. EHD will notify the applicant If any EHD files oxist. An appointment for review will ha 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 ttie same condition as released will be reorgaillzed by EHD Z;Uff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a$23.00 deposit prior to review. <br /> 5. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 8. Applications received after 3:00 pm will be processed the next business day. <br /> CbNFiRMI~D APPOINTMENT 13ATE TIME; <br /> 'i <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EHD 4"2-Wo" <br /> 902061 <br /> r <br /> 1 <br /> i' <br /> I <br />