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10/321/2002 14:21 464013E EN/1RONMENTAL HEAL <br />V ^ SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br />10 <br />C� ENVIRONMENTAL HEALTH DIVISION <br />7 r <br />304 EAST WEBER AVENUE, THIRD FLOOR I <br />STOCKTON CA 95202 <br />(209)460-7420 <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT BUSINESSIAGENCY <br />ADDRESS•-Z5�5- A w, <br />PHONE 1 frl/�EG� v�Y7K�'7/�ZfrLTNh-Gl ✓kC%i(� <br />7J' �C 'o� 3 FAf.SiMILE <br />PAGE 01 <br />rlml uw�cn <br />lu u� <br />lu�'u1 i <br />NOV 0 12002 <br />TENTATIVE'APPOINTMENT DATE o / 0.2- TIME /,r,4t- . AN, <br />(%easa elvs 7 to 10 huslndss day's from dale of ■ppllcatlon submittal) <br />❑ CHECK BOX TO EXPEDITE REQ EST.* E EO�UE`ST 0 3 S <br />SIGNATURE OF APPLICAN �u �, " 51A F A 3/ OZ ' <br />O <br />N <br />O <br />N <br />y ENVIRONMENTAL HEALTH DIVISION FILES NOV 12 2002 <br />LV UNDERGROUND TANK (UST) CLEANUP SITE (LOP) O HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br />OTHER CLEANUP SITE (NON -LOP) 0 FOOD FACILITY O SOLID WASTE VEHICLE <br />,TTf UNDERGROUND TANK (MDNIIORINGIREMOVAL) 0 DOG KENNEL 0 DAIRY <br />O HAZARDOUS WASTE GENERATOR O CHICKEN RANCH 0 PKO TREATMENT PLANT <br />0 TIERED PERMITTED FACILITY 0 MOTELIHOTEL 0 PUMPER TRUCK/YARDICHEM TORETS <br />0 TATTOOMODY PEIRCING 0 POOUSPA 0 LAND USE APPLICATION SITES <br />O MEDICAL WASTE FACILITY 0 PUBLIC WATER SYSTEM 0 OTHER (PLEASE SPECIFY ABOVE) <br />1. List up to ten addresses In the Spate above. Select the type(&) of files from the list above by chocking <br />the appropriate box(es). At least one filo type MUST be selected. Fax to (209) 464-0138 or mall to the <br />address Indicated above_ <br />2. EHD will notify the applicant i1 any EHD files exist. An appointment for review will be confirmed <br />approximately five business days but no later than ton (10) drys 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 />7. A file that.is actively being worked on by EHD staff may not be Immediately availnbie for review. A now <br />application may be submitted when the file Is available. - <br />4. Any file not returned In (he same condition as reloased will be reorganized by EHD slaff 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 />G. 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 />f -d olLb=SO 20 16 a00 <br />..THIS <br />SIPE END STAFF 6S NCY <br />PROGRAM <br />FilU�r <br />L►7 tii'I�3/ill�i��1�7GI9.7=Ti- <br />=���= <br />M•M1 • <br />, I . <br />r 4 <br />�m_1L13� CLIA"+t�ii`•�1 <br />. .a��:—' <br />1SWUMM <br />MENEM WAR I <br />TWA <br />, .�tt3ft�f��� �iillll�'AIU11 M It-71�L1111� <br />�L�luL�nI�LIL711LIU� <br />O <br />N <br />O <br />N <br />y ENVIRONMENTAL HEALTH DIVISION FILES NOV 12 2002 <br />LV UNDERGROUND TANK (UST) CLEANUP SITE (LOP) O HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br />OTHER CLEANUP SITE (NON -LOP) 0 FOOD FACILITY O SOLID WASTE VEHICLE <br />,TTf UNDERGROUND TANK (MDNIIORINGIREMOVAL) 0 DOG KENNEL 0 DAIRY <br />O HAZARDOUS WASTE GENERATOR O CHICKEN RANCH 0 PKO TREATMENT PLANT <br />0 TIERED PERMITTED FACILITY 0 MOTELIHOTEL 0 PUMPER TRUCK/YARDICHEM TORETS <br />0 TATTOOMODY PEIRCING 0 POOUSPA 0 LAND USE APPLICATION SITES <br />O MEDICAL WASTE FACILITY 0 PUBLIC WATER SYSTEM 0 OTHER (PLEASE SPECIFY ABOVE) <br />1. List up to ten addresses In the Spate above. Select the type(&) of files from the list above by chocking <br />the appropriate box(es). At least one filo type MUST be selected. Fax to (209) 464-0138 or mall to the <br />address Indicated above_ <br />2. EHD will notify the applicant i1 any EHD files exist. An appointment for review will be confirmed <br />approximately five business days but no later than ton (10) drys 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 />7. A file that.is actively being worked on by EHD staff may not be Immediately availnbie for review. A now <br />application may be submitted when the file Is available. - <br />4. Any file not returned In (he same condition as reloased will be reorganized by EHD slaff 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 />G. 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 />f -d olLb=SO 20 16 a00 <br />