Laserfiche WebLink
_ 17/30/2002 13:48 209467" 8 AGE STOCKTON PAGE 02/02 <br /> PATE REGEIvGp ens�vv vn.ocn <br /> SAN JQAQUIN COUNTYPUBLIC HEALTH #VICES ?V'511 IRONMENTAL HEALTH DIVISION <br /> 5 ,^ <br /> :. g„ 0 AST WEBER AVENUE,THiRr1XLLQ <br /> STOCKTON CA 95202 <br /> (209) 468-3420 j <br /> PUBLIC RECORDS RELEASE APPLICATION NE <br /> APPLICANT BUSINESS/AGENCY Q . <br /> 'U1411 <br /> ADORESSw <br /> PHONE �Dn ' <br /> FAC! MILE 6 <br /> TENTATIVE"APPOINTMENT DATE 9 TIME <br /> (Please give 7 tCL 10 bus 1ne s from date of ap lic <br /> da atlon submittal) <br /> TO EXPEDITE REQUE -S 8.0 EE�'U RO &I BUSINESS DAYS <br /> CHECK 80X �f <br /> SIGNATURE OF APPLICANT DATE / 3� <br /> FILE ADDRESS <br /> 1 qvit rDn <br /> 1k tt 1( Ir ✓)1a <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FAGIUTY <br /> OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> TIERED PERMITTED FACIt rlY ❑ MOTEL/HOTEL O PUMPER TRUCK/YARD/CHEM TOILETS <br /> C3TATTOOIBODY PEIRCING 173POOL/5PA Q LAND USE APPLICATION SUES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM o OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ton 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)_464-013Q r mail to t <br /> address indicated abo <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 flle 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 $78.00 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 YE5 NO 12EVIEW DATE <br /> � oo a 01104!04 <br /> n <br />