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• v Ili d AGE STOCKTON - PAGE Jl/Ui <br /> OATS ftEQE1Vc0 FHU LOG HUMet8 <br /> SAN JOAN COUNTYPUBLIC HEALTH S VICES <br /> CRONMENTAL HEALTH DIVISIC �f f <br /> FEB 2 7 2003 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON 95202 <br /> 1111IF,( I IL;;�I I �r ' i u (209)468-3-3 4200 ✓� <br /> D PU LIC RECORDS RELEASE APPLICATION <br /> APPLICAN USINESSIAGENCY LIdualyd lea Fnu/��2'1 Pn <br /> ADDRESSAO C( s6n <br /> /q �f Q 4: /tri _ <br /> PHONE (ao4 Yl 7- 166 FACSIMILE l 0(�9 / -1110 l/7 <br /> TENTATIVE"APPOINTMENT DATE TIME ' I-t)3 �cl6pl � <br /> (Please give 7 to 10 business days from date of application submittal) <br /> CHECK BOX TO EXPEDfrE REQUE T-$Vf.00 FEE—REQUEST GESS 0 I 3 BUSINESS OAY5 � J <br /> SIGNATURE OF APPLICANT DATE: <br /> FILE ADDRESS I <br /> s CIO ged, <br /> Lu IDLUU L6 U LL or <br /> -- A <br /> Ono <br /> weaft <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) O HOUSING ABATEMENT C SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WA31E VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR Cl CHICKEN RANCH G PKG TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑ MOTELfHOTEL C PUMPER TRUCIUYARD/CHEM TOILETS <br /> ❑ TATTOOISODYPEIRCING ❑ POOUSPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY O 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 rttall 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 shculd be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by END 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,EFID staff at the expenso <br /> of the applicant. Future file reviews by the same applicant may require a $0.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. Q9 a9_ <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 />