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09/19/2002 16:03 209-579-2225 MODESTO ATC PAGE 01 <br /> �! SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 00304 <br /> EAST WEBER AVENUE �THIRD FLOOR , <br /> STOCKTON CA 05202 <br /> I (200) 468-3420 <br /> _ <br /> PUBLIC RECORDS RELEASE APPLICATION qp 1,9 2002 <br /> APPLICANT ��-$4V AllPt' BUSINESSIAGENCY /'TTG- f�SScxrAT iIR(1NMENT HEALTH <br /> ADDRESS ///7 Lo�.,j& P j_yAAV6 5ty7t .Q �, tmDasmo CC <br /> Z / / <br /> PHONE ` ,� 'S —���� FACSIMILE CW9 �_57g" Z�z5 <br /> TENTATIVE'APPOINTMCNT DATL' �Q L TIME �Q • a I <br /> (Please Dive 7 to 10 bu:inc&a days fro ala OI app l' Allan sWminAl) <br /> 11 CHECK BOX TO,EXPEDITE REQUEST- �F-RE UE RD D IN USINESS DAYS <br /> SIGNATURE OF p:PPLICANT DAT[ 2— <br /> FILE <br /> -FILE ADDRESS THIS SIDE CMD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> WWII <br /> V <br /> T L A! <br /> �� MI _ �uu <br /> LOA <br /> V O <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> 7l OTHER CLEANUP SITE(NON-LOP) O FOOD FACILITY O SOLID WASTE VEHICLE <br /> -ay UNOCKGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PRO TREATMENT PLANT <br /> C3 TIERED PERMITTED FACILITY ❑ MOTELfHOTEL O PUMPER TRUCK7YAfiD/CHEM TOILETS <br /> ❑ TATTOOIBODY PIERCING O POOLISPA ❑ LAND USE APPLICATION STYES <br /> O MEDICAL WA5T9 FACtuTY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ton addresses in the space above. Select tho type(s) of files from the list above by chocking <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 tan (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 tho same applicant may require a $87.00 deposit Prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 5. Applications received atter 3:00 pm will be processed the next business day. <br /> LRE <br /> NFIRMED APPOINTMENT DATE TIME <br /> E CONFIRMED PHONE FAX INITIALS <br /> IEWED YES NO REVIEW DATE 9 __ <br />