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FROM NOR Environmental PHONE NO. : 209 369 4228 Dec. 23 2002 12:25PM P4 <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES uw tuo suasm <br /> 'ENVIRONMENTAL HEALTH DIVISION <br /> y 304 EAST WEBER AVENUE,THIRD FLOOR <br /> DEC 2 3 2002 STOCKTON CA 95202 <br /> (209)468-420 <br /> �PIJBLIC RECORDS RELEASEAPPLICA71ON <br /> APPLICANT L/IC_ CP/7 BUSINESS/AGENCY <br /> ADDRESS <br /> PHONE-&6367-'3-20( FACSIMILE 22 ,S a <br /> TENTATIVE*APPo1NTMENToATE ,.A. 6. 2663 <br /> TIME <br /> (Please give 7 to 10 business days from date of appllcaHon submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$89.00 FEE-RE ES PROCESSED IN 3 BUSINESS OAYS � I q <br /> SIGNATURE OF APPLICANT DATE / 432-- <br /> • OFILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> Lod, C4 <br /> 1"4� 3 S. vlut C <br /> 3 <br /> o c. [� : ftftft <br /> O17,7,6 CA <br /> I, ::T <br /> r. O <br /> OT WO M MA <br /> \V. 4 ( OZ �{. [,�Y. -• ^. (.&A (-A i moi/ <br /> S <br /> Ef <br /> O <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ c <br /> HOUSING ABATEMENT SOLID WASTE FACILITY <br /> Or OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACRJTY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL O DAIRY <br /> 1J HAZARDOUS WASTE GENERATOR O CHICKEN RANCH O PKG TREATMENT PLANT <br /> ❑ TIEREO PERMrrTED FACILJIY ❑ MOTEI.MOTEL ❑ PUMPER TRUCWYARD/CHEM TOR.M <br /> ❑ TATTOO/BODY PEIRCtNG ❑ POOLWA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUHUC WATER SYSTEM IR-OTHER(PI-EASE SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above. Select the type(s)of Tiles from the list above by checking <br /> the appropriate box(es). At least one file typo MUST be selected. Fax to(209)464-0138 or mall 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(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 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 day. <br /> CONFIRMED APPOINTMENT DATE, TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br />