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e ErlvlrorxnentaI �. FAX NO. : 2095690295 .,.Tian. 15 2003 11:53AM P2 .. <br /> �� <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES I I <br /> JAN 1 5 2003 ENVIRONMENTAL HEALTF{DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> ENVIRONMENT HEALTH STOCKTON CA 95202 <br /> PERMIT/SERVICES (209)458-3420 <br /> PUBLIC RECORDS RELEASE APP <br /> LICATIOtI 4 <br /> APPLICANT �77PI/e. /g"j <br /> k t'v YIG( BUSINESSIAGENCY <br /> ADDRESS 7 M QM e <br /> PHONE '!G� �i2q FACSI�MIILE' �� / 0. 95 I 1-03�1l- <br /> TEN7AT{V E-APPOINTMENT DATE' <br /> /// TIME � 1 ��.+"..,, <br /> �qr� (Please Dive T to 10 business tlays Ir°m Ual°°I apPlicati°^submittal) <br /> un, <br /> � <br /> yA EHECK BOX 70,L•XPEDI7E REQUEST-507.00 FEE QUhS EysC^'N 3 BUSINESS DAYS <br /> A _'y DATE ��-- <br /> SIGNATURE OF b(PPLICANT / /'- O _ <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY ` <br /> PROGRAM CLEMENTS SEARCH - <br /> H <br /> ' qd I W• o I <br /> •r— ENVIRONMENTAL HEALTH DIVISION FILES <br /> O HOUSING ADATEMENT ❑ SOLID WASTE FACILITY <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) D FOOD FACILITY D SOLID WASTE VEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) ❑ DAIRY <br /> UNDERGROUND TANK(MONRORING/REMOVAL) D DOG KENNEL C3pKG TREATMENT PLANT <br /> HAZARDOUS WAS3E GENERATOR Cl CHICKEN RANCH ❑ PUMPER TRUCK/YARDICHEM TOILETS <br /> ❑ TIERED PERMITT O FACILITY ❑ MOTEl1t10TEL' <br /> rt O LAND USE APPLICATION SITES <br /> ❑ 7ATTOOIBODT PIJIRCING - D PUBLIC A "' <br /> ❑ MEOICAL WAST4 FACILITY O PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ADOVE) <br /> 1. List up to ten addresses in the space above: Select the types) of files <br /> tfrfrom <br /> the <br /> 4list <br /> 0138 or myai hocto king <br /> the appropriate box(es). At least one file type MUST be selected. <br /> Fax 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. Futuro 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 /> G. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> I DATE CONFIRMED PHONE FAX INITIALS <br /> a. <br /> REVIEWED YES NO REVIEW DA7F <br />