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r <br />DATE RLCENEq EHD LOO NUIMR <br />SAN JOAQUIN COUNTY <br />I:.NVIRONMENTAL HEALTH DEPARTMENT <br />flr ",Y 1 6 1 103 304 EAST WEBER AVENUE, THIRD FLOOR <br />STOCKT©N CA 95202 <br />Y L; N (209) 468-3420 <br />_ PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT BUSINES8lAGENC'f� <br />CA Y,5 TY <br />PHONE _ FACSIMILO- - I <br />TIME � •/� � - L� <br />TEN I A 11 V E )' PPOw,114 ENT DATE <br />(131 m54 give 7 to 10 business clays fron date of appllcatlon submittal) <br />7 RE VEST P OC IN 3 eUSINESB DAYS <br />L40#1 <br />- N' QUEST -I' 9 F[E Q 3 <br />t,HE�7K80:YTO EX LDIILRE. � <br />SIGNATURE OF /lPi'LIC:ANT �( DATE <br />?NYS !SIDE 6HD a Wr USAM P E ONLY <br />FILE Al:DRES3 PROGRAM ELEMENTS SEARCH <br />t, Ay, <br />T <br />ENVIRONMENTAL EAL'rH DIVISION FILES <br />e? <br />)+ UND[RGROUND TANK (1A;T) Ci -F -I NUP TOTE (LOP) ❑ HOUSING ABiJEMENT In SOUD WASTE FACILITY <br />i ❑ O'THE;R CLEANLIP SITE (?-OWLOP1 ❑ FOOD FACIU-,Y © SOLID WASTE VEHICLE <br />UNDERGROUND Vj%?1K (AlONITORINGIREMOVAL) ❑ Do0 KENNLL ❑ DAIRY <br />CJ HAZARDOU:; WA13TI: OE 411RATOf: O CHICKEN RAIICH ❑ PKG TREATMENT PLANT <br />❑ TIERED PERMITTIED FAC LITY 0 MOTELIHOTEL ❑ PUMPER TRUCKYYARDYCHEM TOILETS <br />171 TATT001BODYF Cr\ 171 POO�Pq ^rr <br />d MEUI(,AL WASTE- ACIu rlM�u(PL SF SPECIFY) N S <br />r(V <br />NJ v <br />�> <br />1. List up to ten address;es in the space above. Select the type(S) of files from the list above by checking <br />the appropriate bax((,$). At least one file type MU aT be selected, Fax to (209) 4b4-0130 or mail to the <br />Aireu Lin-c-rissiteo above <br />2. EHD will notity 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 fl)r a nta►:imum of five business days for review. Appointments Iahould be scheduled <br />accordingly, <br />3. A file that is <,ctive,ly being worked on by EHD sta'f may not be immediately available for review. A new <br />applic ition rr uy b,; siubmltted when the file is available. <br />4, Any file not 1,7Iturriad in the same condition as reloased will be reorganized by EHD staff at the expense <br />of the appliciint. Firture file reviews by the same applicant may require a $84.00 deposit prior to review. <br />*TENTATIVE appointment dates must be confirm,W with EHD staff. <br />G. ApplicutiOns I'ecuiv(l d after 3:00 pm will be proce:►sed the next business day, <br />