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4w L All <br /> SAN JOAC I COUNTYPUBLIC HEALTH SEP' "'ES <br /> RCRr ( 'i ` EN�t ONMENTAL HEALTH DIVISIONs� �L�Q� <br /> '.5�'hji 'rjLcf L�i 304 EAST WEBER AVENUE,THIRD FLOOR �F' <br /> STOCKTON CA 95202 <br /> MAY 1 0 2001 (209) 468-3420 <br /> ENVIE; it,l ,tr PUBLIC RECORDS RELEASE APPLICATION <br /> FiPAITn . I� <br /> APPLICANT `'�ii.(..' "`SA� BUSINESSIAGENCY <br /> ADDRESS -2-07' <br /> 6.ZA+ 1-� cANM Gt ✓o �3 Src 4S zo 7 <br /> PHONE 7 — 7 Z ov FACSIMILE 7u4 0'3 3 _ <br /> • <br /> TENTATIVE'APPOINTMENT DATE TIME <br /> (Please give 7 to 10 business da=from date of application submittal)UN/T✓r 3, 64. MAY 11 <br /> CHECK BOX TO EXPEDITE REQUEST-$a`0 FEE-REQU ESSED IN J BUSINESS DAYS 2001 <br /> SIGNATURE OF APPLICANT T �' <br /> \\� DATE <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> tA <br /> i <br /> p O <br /> _ tA <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> 7CD UNDERGROUND TANK(UST) CLEANUP SITE(LOP))0HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> ' OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) C3 DOG KENNEL ❑ DAIRY <br /> k17 <br /> 'Eli /HAZARDOUS WASTE GENERATOR 11 CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ MOTEL/HOTEL ❑ PUMPER TRUCKIYARDICHEM TOILETS <br /> TIERED PERMITTED FACILITY ❑ pOOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICALTATTOOIBODY <br /> WAS PEIRC FACILITY <br /> ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> ❑ MEDICAL WASTE FACILITY <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 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 TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EH 00 14 00107/40 <br />