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10/30/2002 08:20 925283612.1 AEI CONSULTANTS (50 PAGE 02 <br /> v 10/28/2002 11:26 464013E_ ENVIRONMENTAL HE i PAGE e3 <br /> 4 EIID 40C MA10EH <br /> 'oqq SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES I �� <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> (209)468-3420 <br /> l <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT <br /> ADDRESS <br /> ��j�lb 1• `Ivt'�`(1��. S -�'A —k�,q�-,S\� �"^--"�12---ice- "�'\'-( l <br /> PHONE `"tc� J'd��i' O��pYI(l�5 I-AdelFAILE <br /> TENTATIVE`.APPOINTMENT DATE�_C 1SA TRAE <br /> iPlcasa Riva T to 10 buSInaS9 days f m date of appllCatWr,SUbMIIIaI) <br /> CHECK BOX TO EXPEDITE REQUEs - E P S @UL4 DAYS <br /> SIGNATURE OF APPLICANT <br /> —`` / DATE <br /> J=FILI ADDRESS THIS SIDE EHD STAFF USE ONLY O <br /> PROGRAM ELEMENTS SEARCH <br /> aY-ctir <br /> D <br /> SOS <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT 0 SOLID <br /> WASE VEHICLE <br /> ❑ OTHER CLEANUP SITE(NON-LOP) O FOOD FACILITY <br /> P,UNOERGROUND TANK IMONRORING,REMOVAL) 0 DOG KENNEL O DAIRY <br /> O CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> OHAZARDOUS WASTE GENERATOR ❑ PUMPER TRUCKrrARD,CHEM TOILETS <br /> TIERED PERMnTED FACILITY In POOMPATEL CO LAND USE APPLICATION SITES <br /> O TATTOO,BDDY PEIRGING ❑ PUBLIC WATER SYSTEM O OTHER(PLEASE SPECIFY ABOVE) <br /> ❑ MEDICAL WASTE FAGIUYr <br /> 1. <br /> List up to ton addresses in the space above. Select the types) of files from the list above by checking <br /> the appropriate bax(as). At least one file type MUST be selected. Fax to (2091464-0138 or'mail tot e <br /> addressindicaI above. . ' <br /> 2 EHD wilt notify the applicant if any F_HD files exist. An appointment for review will be Confirmed <br /> approximately five business days but no later than ton (10) day$ after receipt of application. The tiles <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> A file that js,actively being worked on by EHO 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 Ih 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 /> g. Applications received atter 3:00 pm will.be processed the next business day. <br /> rIDATE <br /> FIRMED APPOINTMENT DATE. TIME <br /> CONFIRMED PHONE FAX INITIALS <br /> EWED YES NO REVIEW DATE <br />