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09/>>1''7/2003 09:37 FAX 209 9480821 0 003/004 <br /> Y F MLOGNUM9 <br /> SAN JOACQUIN COUNTYPUBUC HEALTH SERVICES <br /> / ENVIRONMENTAL HEALTH DIVISION <br /> SEP 17 2003 304 EAST WEBER AVENUE,THIRD FLOOR <br /> ENVIRONSTOCKTON CA 95202 1 <br /> (v1ENT NEAL(H (209) 468-3420 <br /> PER%41T/SERVICES PUBLIC RECORDS RELEASE <br /> �A�PPLICCA'TIION <br /> APPLICANT 1 ,.� 51�71C LIr�� DUSINEESSSIAGENCY I T'I t3 f�E <br /> ADDRESS �7 x,72)-2L F MJ�t��> 4> C~I�C�C+IZ�a C:=_��1'C7 S- <br /> PHONE— FACSIMILE 2-0!�Z-C7 -O E•.Z I <br /> TENTATIVE"APPOINTMENT DATE q/2.4- /03 Time /2'vv <br /> (Please give 7 to 70 days from date of application submittal) a <br /> CHECK BOX TO EXPEDITE REQUEST-SiI7A0 FI E- QUEST PROCESS"3 BUSINESS DAYS 1 !�\\ <br /> SIGNATURE OF APPLICANT DATE O l, ,J <br /> FILE ADDRESS THIS SIOE EHD STAFF USE ONLY <br /> PROGRAM ELEE 4EAFCH^, <br /> tu <br /> (. 100 f4. tin t t w 9-1 c�A #—MT)n .rFr1 rpm <br /> 3 1% tzo <br /> D u <br /> L-IS46 IJ. w,1- Da wa <br /> VO Vtx. tlIt LA V5 <br /> y0 Lo �SA00 AJF..J�A `� i� <br /> ENVIRONMENTAL HEALTH DIVISION FILES V <br /> gt UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT W SOLID WASTE FACILITY - <br /> 1P OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACIUJTY O SOLID WASTE VEHICLE <br /> Pt UNDERGROUND TANK(MONITORINGfREMOVAL) ❑ DOG KENNEL J;) DAIRY <br /> 01 HAZARDOUS WASTE GENERATOR Cl CHICKEN RANCH IS PKG TREATMENT PLANT <br /> d TIERED PERMITTED FACI❑TY ❑ MOTE❑HOTEL ❑ PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑ TATTOOIDODY PEIRCTNG ❑•pdouIsm - • tel LAND USE APPLICATION SITES <br /> Q MEDICAL WASTE FAciuTY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ADOVE) <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 (2091464-0138 or mall 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 /> ;• 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> Applications received after 3:00 pm will be processed the next business day. <br /> ONFIRMED APFOINTMENT DATE TiME. <br /> 4TE CONFIRMED PHONE FAX INn]ALS <br /> :VIEWED YES NO REVIEW DATE <br />