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SAN JOAQUIN COUNTYPUBLIC HEALTH VICES NUMU/n c� <br /> VIRONMENTAL HEALTH DIVISIIf <br /> a EAST WEBER AVENUE,THIRD FLOOR �— <br /> STOCKTON CA 95202 <br /> (209) 468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT 10AARD BUSINESSIAGENCY &t0-_PgnmE IN C . <br /> ADDRESS -'al3 7 VCN�WLWK f><,1C *iSZ�-1 c7 t�Aol.�tS-lZa LQ `1ra3 St. <br /> PHONE 209 50 O11,I3 FACSIMILE aO°I 61.09 CIA r ' <br /> TENTATIVE'APPOINTMENT DATE MA,(ZLH I011000 TIME 00/065 <br /> (Please give 7 to 10 business days from date of application submittal) received <br /> © CHECK BOX TO EXPEDITE REQUEST-$78.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS MAR — <br /> 7 20nn <br /> SIGNATURE OF APPLICANT DATE 040-7100 <br /> IMMIMInIll Ir! <br /> FILE ADDRESS U UU air U9D <br /> I rJ ST-v <br /> V SW tFT Anfs[h�11� rlgl 5W FT k -��1 Pel+a n &0 6,/c IIAO <br /> rEi75 SHELF 2.0 W Ct40,Q-TC:9_ W <br /> V �pLOMi3UITnseANA. lyy S,1,11.fceLrJ wa <br /> LAe- FA2'bt5 (111 WAVY veINl `- roe; <br /> • <br /> fJ -T42,VCKSTOP 160% Ot lo'-� H YZAI1 O <br /> v Slonl (-1.'515 U.1. GNrt <br /> O MIF t.0 t J I C D S-r, CCJ. 939 W. G.\,t LT-E t <br /> I rfrt�-mss,->�t� rrdM�� rla- 02-S NAVY 90VC, Lir, <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> 09 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> IR OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> R UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> ® HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTEUHOTEL ❑ PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑ TATTOO/BODY PEIRCING ❑ POOUSPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <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 $78.00 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 NO REVIEW DATE <br /> EH 00 14 0/105/00 <br />