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UU/u3/UZ TUE 07:07 FAX 415 892 9475 PES ENVIRONMENTAL a001 <br />'08/30/2002 15:34 <br />+s q1g <br />". w 1 1� <br />203433 FIFTH FLOM ' PAGE 02 <br />SAN JOAQUIN COUNTYPU13LIC HEALTH SERVI ' <br />ENVIRONMENTAL HEALTH, DtVISIQN <br />y <br />304 EAST WEBER AVENUE, THIRD FLOOR <br />STOC"ON CA 95202 <br />(209) 468-3420 li <br />PUBLIC RECORDS RELEASE APPLICATION SEP 0 3 2002 <br />APPLICANT SAO L Ci eA N►,4ruid gUggl rs AOENCY <br />S L M+I <br />NT <br />ADORES$ <br />( 4''� Z i-1 o V l�'7ro II I..J D . r � T� ! a O r }{ o �l'."I'a C. A• `1 `� �{ <br />PHONE `(1 �'~• a � IG O n pAGc$WIILP Lit a~ $ ,' — <br />19.rza► q <br />TIENTAT IVE". APPOINTMENT DATE R I Z a Z i TIME i :•ti . • _". <br />tPleasagivep �, Sr0m 1 ypfit submiltall <br />CHECK BOX TO EXPEDITE REQUEST . $09.00 EE - REQUEST PR()CES 30 INESS DAYS <br />SIGNATURE OF APPLICANT DATE S <br />ENVIRONMENTAL HEALTH DIVISION FILES ti <br />/ F <br />e NDERGROUND TANKIUST) CLEANUP SITE (ROP) Q HOU51NO ABATEMENTIiB SOLID WASTE FACILITY <br />Iff OTHER CLEANUP srm (NON -Lop) D FOOD FACILII Y fl $O}.ID WASTE VEHiCLg <br />R( UNDERGROUND TANK (MONITORINGIREMOVAL) ❑ DOG KENNET. � ❑ DAIRY <br />WHAZARDOIIS WASTE GEWRATOR 0 CHICKEN RANCH I, 0 PK(; TREATMENT PLANT <br />to TIERED PERHUTTED FACILITY 13 MOTSLINOTEL fl PUMPER 1RUCWTARDiCHEM TOiLr4IS, <br />❑ TATTOOIeODY PV9RCING 0 POOLISPA ill 0 LAND USE APPLICATION SITES <br />0 MEDICAL WASTE FACILITY 13 PUBLIC WATER SYSTEM Q OTHER (PLEASE SPECIFY AROVE) <br />1. List up to ten addresses In the space above. Select the type(s) of files from the list above by ctletking <br />the appropriate box(es). At least ane tilt type MUST be selected: Fax to (2091464-01;8 or mall tot e <br />address Indi ted a ' ve. <br />2. EHIJ will notify the applicant if any EHD files exist. �An ap IpoIntmant 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 b�ing worked an by EHD staff may m! t bo Immediately avallable for review. A new <br />application maybe submitted when the file Is avallabte. I <br />4. Any file not returned IA 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 803.00 deposit prior to review. <br />S. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br />a. Applications received after 3:00 prn will be }processed the next business day. <br />i1 <br />;r <br />CONFIRMED APPOINTMENT DATE. TIME . <br />DATE CONFIRMED _ ,_ PHONE= {'FAX INITIALS <br />Ft !WED YES NO REVIEW DATE "' <br />FILE ADDRESS <br />�{ <br />IL <br />THIS SIDE EHD STAFF Use ONLY <br />PROGRAM ELEMENTS SEARCH <br />'J -C- IF1 <br />S. <br />A R 4 C tali u+q f'T'o C K-ror1 <br />I} <br />3 2-4 L <br />S . C- t- DaRhbo 5-rat!gtT S-racrc-rrar/ <br />Z7 CO <br />S. <br />CAL1Ko¢-r{t <br />X50 <br />S. <br />EL DOILA00 5TU$PM,4Tocic-Tdr-1 <br />_ ,, <br />Z�I07- <br />5 . <br />cwL; FaRr4,h r71 o -r s-roCjrrr-oq <br />, r <br />$Tock -7-b.,( <br />LJL 090. Oo S-ra.e3t3 � 7'nc.Ie^7Or! <br />S M i-rQdT 5i"ocpc't•�r-f <br />ii <br />'} <br />ENVIRONMENTAL HEALTH DIVISION FILES ti <br />/ F <br />e NDERGROUND TANKIUST) CLEANUP SITE (ROP) Q HOU51NO ABATEMENTIiB SOLID WASTE FACILITY <br />Iff OTHER CLEANUP srm (NON -Lop) D FOOD FACILII Y fl $O}.ID WASTE VEHiCLg <br />R( UNDERGROUND TANK (MONITORINGIREMOVAL) ❑ DOG KENNET. � ❑ DAIRY <br />WHAZARDOIIS WASTE GEWRATOR 0 CHICKEN RANCH I, 0 PK(; TREATMENT PLANT <br />to TIERED PERHUTTED FACILITY 13 MOTSLINOTEL fl PUMPER 1RUCWTARDiCHEM TOiLr4IS, <br />❑ TATTOOIeODY PV9RCING 0 POOLISPA ill 0 LAND USE APPLICATION SITES <br />0 MEDICAL WASTE FACILITY 13 PUBLIC WATER SYSTEM Q OTHER (PLEASE SPECIFY AROVE) <br />1. List up to ten addresses In the space above. Select the type(s) of files from the list above by ctletking <br />the appropriate box(es). At least ane tilt type MUST be selected: Fax to (2091464-01;8 or mall tot e <br />address Indi ted a ' ve. <br />2. EHIJ will notify the applicant if any EHD files exist. �An ap IpoIntmant 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 b�ing worked an by EHD staff may m! t bo Immediately avallable for review. A new <br />application maybe submitted when the file Is avallabte. I <br />4. Any file not returned IA 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 803.00 deposit prior to review. <br />S. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br />a. Applications received after 3:00 prn will be }processed the next business day. <br />i1 <br />;r <br />CONFIRMED APPOINTMENT DATE. TIME . <br />DATE CONFIRMED _ ,_ PHONE= {'FAX INITIALS <br />Ft !WED YES NO REVIEW DATE "' <br />