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Fpb 25 04 01 : 13p KRnZnN S. ASSOCIATFS 916 564 2222 p. 2 <br /> 02106/2004 12:12 4640136 ENVIRONMENTAL HE4LTH rases U1 <br /> \ ' ✓ _ v- env s..0 nv....� . <br /> V DATE RECEIVED SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL JjEALT13 DEPARTMENT <br /> 304E Weber Ave 3'" Stockton,CA Floor 95205 <br /> aquin20 Fax: (209)464-0138 Web:ww�v.co.san-jo �in.ca.us/chd lJ <br /> F E B 2 5 2004 )?U]B IC RECORDS RELEASE APPLICATION <br /> NN641AEPkita latnINESS1AGENCY: <br /> PFRfA,"CES <br /> �t ADDREss: <br /> FACSIMILE: <br /> PHONE: <br /> TENTATIVE'APPOINTMENT DATE. TIIne: <br /> (Please allow 44 bualneta days from date of aP94+CA010n <br /> CHECK BOX TO EXPEDrrE REQUEST- 3. -REQUEST PROCESSED IN 7 BUSINESS DAYS <br /> DATE f <br /> SIGNATURE OF APPLICANT DeRartment U3e ONY <br /> UN1T j} <br /> FILE AD»RE' 3S I qv" � U <br /> C3/ . GIS S u l�L ❑ Unit I <br /> „ NKu/V G G/ <br /> .J� r �t/�/I ufAr /! L rt/r Unit 2 <br /> c <br /> it 3 <br /> ts. strxt <br /> 9. + G Unit 4 <br /> s Q ❑ Unit 5 <br /> 0 <br /> 9. 9treat <br /> t7. 9M - <br /> ENVIRONMEN'TAL HEALTH DEPARTMENT FILES <br /> SOLID WASTE FACILITY <br /> j <br /> UNDFRGROUtID TANK(UST)CLEANUP SITE(LOP) EHOUSING rtENT D SOLID WASTE VEHICLE <br /> ❑ <br /> OTHER CLEANUP SITE(HON-LOP) 0 FOOL)FACILITY DOG KENNEL ❑ VAIRY <br /> UNDERGROUND TAMK(MONITORINGJREft'tiOVAL) <br /> CJ CHICKEN RANCH :3PKG TREATMENT PLANT <br /> X'HAZARDOUS WASTE GENERATOR p wAQTELMpTEL ❑ PUMPER TRUCKrYARDICHEm TOILETS <br /> ❑ TIP-RFD PERMMED FACILITY ❑ MOTE FHO M LAND USE APPLICATION SMS <br /> 0 TATTOO18ODY PIERCING ❑ POOLOTHER(PLEASE SPECfFY) <br /> PA <br /> 0 UEWCAL WASTE FACILITY <br /> 1. List up to ten addresses in the spat+a above elect MUST be select d f fax t files 0m Ittle list above 209 46d 6139 orbY ch <br /> maii to they <br /> the appropriate box(es). At least one file type <br /> address indicated above.. <br /> 2, EHD will noklfy the applicant if any FHD files exist. An appointment for review will be confirmed <br /> approxilmately five business days but no later than ten(10)days after recelpt 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 immey available for review. <br /> diatelnew <br /> application may be submitted when the lite is available. <br /> 4. Any file not returned M the same condition as released will be reorganized a$9 y E D staff <br /> depoprier to ev ew. <br /> the exP81198 <br /> of the applicant. Future file reviews by the same applicanj may 4tirG <br /> 5. 'TEN cations received fterPpointment dates must 3:00 prn willll be process d the next business day. <br /> ed with EHO staff, <br /> 6. Applications <br /> CONFIRMF-D APPOINTMENT DATE TIME <br /> DATE CONFIRMED <br /> PHONE FAX INITMALS <br /> REVIEWED YES NO REVIEW DATE <br /> erto uai� <br /> wzao� <br />