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09/02/2003 07:32 5592687126 TWINING LABS PAGE 01/0 <br /> 10-1177-200nn0 1�:24W FF TO 1559268'7126 P.02 <br /> [E'LJSAN JOAQUIN COUNTYPUBUC HEALTH SERVICES .Hu uuHUMacw <br /> ENVIRONMENTAL HEALTH DIVISION l/� <br /> SEP 0 2 2003 304 EAST WESER AVENUE,THIRD FLOOR 1 <br /> STOCKTON CA 93202 <br /> ENVIRUivivlENT HEALTH (zos) 468-3420 Zo5- L( � _(--0 ( 3 S 1 <br /> PERMIIiSERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> tm\ S <br /> APPUCAN7 I/ r� �{717iM �' BUSINESSIAGFNCY <br /> ADDRESS ? _ '72 <br /> FACSIMILE <br /> TENTATIVE'AppQIHTMENT DATE /�-J + (I TIME. � <br /> (please give 7 to 10 business days from dme otapplfuuon submittal) <br /> CHECK BOX TO EXPEDITE REQUEST=$97 FEE-REQUEST PROCESSED IN J BUSINESS DAYS <br /> _SS / <br /> SIGNATURE OF APPLICANT ,�7� - �'�� <br /> DATE <br /> FILE ADDRESS THIS SIDE END STAFF VSE ONLY <br /> PROGRAM ELEMENTS SEARCH o <br /> uV� <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> `jd'UNDERGRDUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID wAsTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> c�}"��UNDEROROVND TANK(MONITORINGIREMOVAL) O DOG KENNEL ❑ DAIRY <br /> T <br /> `,"AZARDOUS WAM GENERATOR ❑ CHICKFN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY 0 YOTEL(HOT-EL ❑ FumPERTRUCKIvARnjcmEM TOILETS <br /> C TAT7001BODY PEIRCING ❑ POOUSPA ❑ LAND USE APPUCATIONSTBS <br /> C' MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTGA ❑ OTHER(PL EASE SPECIFY ABOVE) <br /> 1, List up to ten addresses in the space above. Select the type(S) of files from the fist above by checking <br /> the appropriate box(es). At tealt one file type MUST be Selected. Fax to 1`209) 464-0138 or mail to the <br /> adtlressindicated above <br /> 2. EMD 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. Appointmonts 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 rile not returned in the Same condition as released will be reorganized by EHA 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 /> 6. '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 /> i <br /> CONFIRMED APPOINTMENT DATE TIME <br /> MATE CONFIRMED PHONE FAX INITIALS <br /> i <br /> EVIEWED YES NO REVIEW DATE <br /> W S4 OYDriDo <br /> l <br /> 70TH_ P.02 <br />