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09/17/2003 09:36 FAX 209 9480621 0002/004 <br /> OATS MCF EO 46 Eno LOG MUMa EA' <br /> r SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION 107 <br /> 304 EAST WEHER AVENUE,THIRD FLOOR <br /> SEP 17 2003 STOCKTON CA 95202 <br /> (209)4683420 <br /> � ;-)O jtlENT tE LTHPUBLIC RECORDS RELEASE APPLICATION <br /> p ';1ViiTIT/St�s�Tv�r L-n <br /> APPLICANT I i+I. Si'I�PC.0-�.S BUSINESSIAGENCY <br /> ADDRESS <br /> PHONE 209 /CiLfa/ I7NS FACSIMILE G �ra �c7N`��y6ZI <br /> TENTATIVE*APPOINTMENT DATE ( �L�/ 0�TIME �Z� <br /> (Please give 7 to 10 buslness days from date of applloatlon submittal) <br /> El CHECK BOX TO EXPEOITE REQUEST•17,00 F —REQUEST PROCESSED IN 3 BUSINESS DAYS ' <br /> SIGNATURE OF APPLICANT DATE V-D C �� <br /> A 7 <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> 3 Q-�— CA _ 35 <br /> 2 I Z . CA FDR,,41P} S i- •r „ 3 <br /> L. r.-1E 0%0t,-. r Ir <br /> M v u Si. <br /> ( L r It Ir <br /> I L' I, Jr <br /> LO <br /> - ENVIRONMENTAL HEALTH DIVISION FILES <br /> I% UNDERGROUND TANK US CLEANUP SITE(LOP) <br /> LOP) ❑ HOUSING ABATEMENT Oa SOLID WASTE FACILITFACILITY <br /> R OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY tl SOLID WASTE VEHICLE <br /> �+ UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL W DAIRY <br /> 4a HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH W PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTEL t3 PUMPER TRUCIOYARDICHEM TOILETS <br /> tl TATTOOIBODY PIERCING C3POOLISPA -" 13 LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses In the space above. Select the type(s)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(209) 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 (10) days after receipt of application. The files <br /> will be held fora 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 Elle reviews by the same applicant may require a $87.00 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 />