Laserfiche WebLink
1A­ <br /> SAN JOAQUIN COUNTY <br /> EN 'ONMENTAL HEALTH DEPARTNIT <br /> ) <br /> EAST WEBER AVENUE, THIRD FLO0*0' <br /> JUN 2 6 2003 STOCKTON CA 95202 <br /> (209) 468-3420 <br /> 1,E <br /> ! L <br /> --""A 1�'PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT Vr BUSINESS/AGENCY 6a(l&x/ <br /> CH /' J— <br /> ADDRESS-3W(7(- 2-( 2 <br /> PHONE 2- 5 0 FACSIMILE 2- Y-7 -r-- —/o <br /> TENTATIVE*APPOINTMENT DATE <br /> TIME2- - <br /> 7 <br /> (Please give 7 to 10 business days from date of application submittal) 7 <br /> • <br /> CHECK BOX TO EXPEDITE REQUEST-$89. FE -REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE -0 <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> kAJ bZf r— L4y'1r__ <br /> MCjr41d/^14 -r, MI,Ij&j0'yA- <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> 6--u—m-IDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT 0 SOLID WASTE FACILITY <br /> p�CPTHER CLEANUP SITE(NON-LOP) 11 FOOD FACILITY 0 SOLID WASTE VEHICLE <br /> En'UNDERGROUND TANK(MONITORING/REMOVAL) 0 DOG KENNEL 0 DAIRY <br /> E"AZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY 11 MOTEL/HOTEL 13 PUMPER TRUCKIYARDICHEM TOILETS <br /> 0 TATTOO/BODY PEIRCING .0 PDOLISPA 0 LAND US PPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY LZ-OTHER(PLEASE SPECIFY) Av-u� av% 4k <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 <br /> REVIEWED YES NO REVIEW DATE <br /> EHD 48-02-006 <br /> 312612003 <br />