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04/10/03 THU 13:02 FAX 925 253 4985 - TREADWELL & ROLLO 1g_J001 <br />j ) <br />SAN JOAQUiN..0 1�10U 'TYPU Ef1o40GMUliU]EN <br />ELIC HEALTH SIERViCES <br />APR 1 0 2003 ENVIRONMENTAL HEALTH DIVISION <br />304 EAST WEBER AVENUE, THIRD FLOO)t ' 3q <br />WIRONMENI HEALTH STOCKTON CA 95202 �LT <br />PF,9 11T/SERVICES (209) 46"420 rAl t,a __�4zZ <br />PUBLIC RECORDS RELEASE APPLiC;ATION <br />APPLICANT _f)Dri i BUSINESS <br />ADDRESS- I � T� zits�1� <br />PNONE. L -L - CJ X i F CS1Mtt,E� <br />TENTATIVE, �- <br />APPOINTMENT DATE _ O 3 TIME <br />�-1 (Please give 7 l0 10 buslnoss days from elaln of appllcat1on subrn1f1Q0 -T / <br />u <br />CHECK BOX TO EXPEDITE REgLIEST 9.0e FEE UkST PRO SED IN 3 BU IN S IAY `y <?G / .i.j .3 <br />5 <br />SIGNATURE OF APPLICANT j - A11-', T <br />_- _(�� - <br />��- <br />ENVIRONMENTAL <br />• <br />FILE:3 <br />UNDERGROUND YANK (UST) CLEANUP SITE (LOP) <br />OTHER CLEANUP 5FrE (NON -LOP) <br />❑ HOUSING ABATEMENT <br />O <br />0 <br />1. Ust Up to ten addresses In the $pace above. Select tho type(s) of files frvm thm list above by checking <br />the appropriate box(es). At least one file type MUST be selected. FoX 1.0 2O9 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 (1(I) days after receipt of application. Thu flies <br />will be held for a maximum of five business days for review. Appointments should be schadulnd <br />accordingly, I <br />3. A file that.f� actively bring worked on by EHD staff may not be immediately av;ail:ible For review, Anew <br />application May be submitted when the file is available. <br />4. Any file not returned if1 the same condition as released will be reorganized by 1=HD staff at the expense <br />Of Cho applicant. Future file reviews by tho same applicant may require a $89.00 deposit prior to inview. <br />S- "TENTATIVE appointment dotes must be confirmed with EHD staff. <br />.6. Applications received after 3.00 pm will be processed the next busincs:; day. <br />CONFIRMED APPOINTMENT DATE. TIME <br />DATE CONFIRMED <br />REVIEWED YES <br />NO <br />PHONE FAX <br />REVIEW DATE <br />INITIALS <br />❑r. Tn1.dh Th _QT 7Q Q7 /; -r IT T <br />ENVIRONMENTAL <br />HEALTH DIVISION <br />FILE:3 <br />UNDERGROUND YANK (UST) CLEANUP SITE (LOP) <br />OTHER CLEANUP 5FrE (NON -LOP) <br />❑ HOUSING ABATEMENT <br />O <br />O SOLID WASTE FACILITY <br />FOOD FACILITY <br />❑ S(:ILM WASIZ VEHICLE <br />UNbERGROUND TANK (MONiTORiNGIREMOVAL) , <br />❑ DOG KENNEL <br />0 D AIRY <br />HAZ,ARDOUS WASTE GENERATOR <br />0 CHICKEN RANCH <br />.0 PIi:G TREATMENT PLAN-, <br />TIERED PERtu17TEo FACILrrY <br />O TATTOO/BODY PEIRCWG <br />O MOTE_UHOTEL <br />❑ PUMPER TRUC:KIYARDIC:HEM TOILETS <br />O MEDICAL WASTE FACILITY <br />❑ PCIOVSPA <br />11 PUBLIC WATER SYSTEM <br />❑ UND USE APIPLIC:ATION SiTES <br />❑ OTHER (PL'E.ANE SPECIFY ABOVE) <br />0 <br />1. Ust Up to ten addresses In the $pace above. Select tho type(s) of files frvm thm list above by checking <br />the appropriate box(es). At least one file type MUST be selected. FoX 1.0 2O9 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 (1(I) days after receipt of application. Thu flies <br />will be held for a maximum of five business days for review. Appointments should be schadulnd <br />accordingly, I <br />3. A file that.f� actively bring worked on by EHD staff may not be immediately av;ail:ible For review, Anew <br />application May be submitted when the file is available. <br />4. Any file not returned if1 the same condition as released will be reorganized by 1=HD staff at the expense <br />Of Cho applicant. Future file reviews by tho same applicant may require a $89.00 deposit prior to inview. <br />S- "TENTATIVE appointment dotes must be confirmed with EHD staff. <br />.6. Applications received after 3.00 pm will be processed the next busincs:; day. <br />CONFIRMED APPOINTMENT DATE. TIME <br />DATE CONFIRMED <br />REVIEWED YES <br />NO <br />PHONE FAX <br />REVIEW DATE <br />INITIALS <br />❑r. Tn1.dh Th _QT 7Q Q7 /; -r IT T <br />