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a [�U I 8_1 Of C0NDOR EA;Td It r% i'c[1o.4a81 N. I/i <br />�o ATER- ._.. tnn wu Y�o SAN JOA lIN COUNTYPUEiLtC HEALTH SEF 'CES U <br />FWIRONMENTAL HEALTH DIVISION`S <br />APR 2 3 2001 304 EAST WEBER AVENUE, THIRD FLOOR <br />aTOCKTON 95262 <br />_-AL1 H (209) 488~3-3 426 <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT <br />1-4nh1 BUSINESSIAGENC`-YY f�jf' <br />ADDRESS190 <br />pl*�Lj:.5A t� <br />PHONE _2_4_:77 FACSIMILE ryal;, <br />— - <br />• <br />TENTATIVE* APPOINTMENT DATE TIME reace <br />t--I (Please give Y to 10 business days frcm date of application submittal A <br />u CHECK BOX TO EXPEDITE REQUEST - $87.00 FEE -REQUEST PROCESSED IN 3 BUSINESS DAYS 'L�r(_, � <br />SIGNATURE OF APPLICANT � Iu.,) Ttrt.Yli&Z DATE l []( <br />..-THIS <br />j& <br />SIDE EHD STAFF- <br />PROGRAM <br />EMIEW-W MI, <br />n <br />/G/ CHHA/i✓c c.. 7. 1 � . <br />(yc c ENVIRONMENT T i ����DE /%?>9+i✓ ��)) ��/���,,' ^'^G/cGC,C- �2140P <br />NDERGROUNO TA K( ST) CLEANUP SIVE (LOPJ"t3TR7Ub7iJC'A�TEMENT �50LID WgSTE �THER CLEANUP TE (NON -LOP) ❑FOOD FACII.TiY 0 SOLID WASTE <br />eiHiNDERGROUND Y NK (MON(TORING(REMOVAL) ❑ DOG KENNEL 0 DAIRY <br />-PP�� HA7ARDOUS WAS E GENERATOR 0 CHICKEN RANCH ❑ PKG TREATMENT PLANT APR 27 ?'1$11 <br />C1 TIERED PERMITT FACILITY ❑ MOTELIHOTEL 0 PUMPER TRUCK/YARDICHEM TOILETS <br />❑ TATTOOIBODY P RCING ❑ PCOUSPA "LAND USE APPLICATKIN SITES <br />❑ MEDICALWAST P 0,117 Z'r0 PUBLIC WATER SYSTEM p OTHER (PLEASE SPECIFY ABOVE) <br />1. List up to ten addresses lin 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 aboye_ <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 $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 <br />DATE CONFIRMED <br />TIME <br />PHONE FAX INITIALS <br />REVIEWED YES NO REVIFW nATI= <br />