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-Jul 02 03 08:57a ESR-SRC 9 16564 4501 P• 2 <br /> ( . i <br /> END LAK NVMIIE0. <br /> DAM RECEIVED SAN JOAC.UIN COUNTY ' <br /> jUL O w 2003 ENVIRONMENTAL HEALTH DEPARTMENT V <br /> 304 EAST WEBER AVENUE,THIRD FLOOR I <br /> STOCKTON CA 95202 <br /> ` -`NLl I�• (209)468-3420 <br /> 'ol PUBLIC RECORDS RELEASE APPLICATION <br /> n USINES-T% E CY i' E"& t)bZL2AL .Ce <br /> APPLICANT �l N � -- ---- <br /> ADDRESS O ry <br /> L� .. a �,S FACSIMILE 1�J <br /> PHONE I /� 1.W <br /> TENTATIVE"APPOINTMENT DATE <br /> TIME �[E�. 45� <br /> (Please glue 7 to 10 business dcye from tlate of appllratlon suhmltlaq , C�s,57 <br /> LLW% <br /> CHECK BOX TO EXPEDITE REQUEST•SBa.DD F -REQU SPROCESSESS OATS r� 6 �1 1 Gl�yl <br /> _ DATE ll �( <br /> SIGNATURE OF APPLICANT <br /> UH EM D STAFF USI:ONLY /rte <br /> \ FILE ADDRESSM ELEMENTS SEARCH \/\ <br /> � —_ — <br /> Cr — • — 4. <'i i.3 <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUS,NG ABATEMENT ❑ SOLID WAS TE FACCJTY -- <br /> OTHER CLEANUP SITE(NON-LOP) 13FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG FENNEL D DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> 13TIERED PERMITTED FACILITY D MOTELIHOTEL D PUTAPER TRUCKIYARDICHEM'TOILE S <br /> ❑ TA7TOWBODY PEIRCING ❑ POOL'SPA 13LAIID USE APP/�pp�ATION SITES 'r� <br /> ❑ MEDICAL WASTE FACILITY OTHER(PLEASE SPECIFY) :H., e U' ,fT <br /> 1. List up to ten addresses In the space above. Select the type(s)of files"'•rom ho list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax tc1?.09)_064-0138 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 la':er then ten(10)days after rDceipt of application. The files <br /> Will be held for a maximum of five busines=_ 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 file 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$89.00 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 clay. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> END 3L <br /> y�vmw <br />