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.8/07/03 TIIU 16:39 FAX 916 366 7013 KLGINFLI-DER 1QJ00'i <br /> DATE RECEmEDEHD LOO MINDER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> .n 'j ZUNI{ 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> L f f-I (209)4683420 <br /> PUBLIC RECORDS RELEAS1/E' APPLICATION <br /> APPLICANT I1S7 <br /> hAJD. C AAJ\_ BUSINESS/AGENCY � 4L.�C1 � I �- <br /> ADDRESS/J�711__W e C .-1 /IJ/0)Zl <br /> PHONE \ 3(CO ) G' I FACSIMILE_( <br /> TENTATIVE'APPOINTMENT DATE TIME <br /> (Please glue 7 to 10 business days from dale of application submittal) 1�■M■■ <br /> CHECK BOX TO EXPEDITE REQUEST-$89.DD FEE–REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANTl)ll i,04 DATE <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH O <br /> 1 051 . an Q V <br /> V 1385 b. J <br /> N4C 5 -� <br /> NV I AUG - _ <br /> ENVIRONMENTAL HEALTH DIVISION FILES AUG 2 0 2003 <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) �1010USING ABATEMENT $<SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL h& DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH / PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELJHOTEL ❑ PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑ TATTOO/BODY PEIRCING ❑ POOIJSPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <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$89.00 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 N0 REVIEW DATE <br /> EHD 4542406 <br /> 3aW003 <br />