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7–jun 25 02 08: 46a QPAGE; 0l. <br /> ! � 06/25/2602 98:26 4038 ENVIRONMENTALvie <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH`SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION � <br /> 304 FAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA SS202 <br /> (209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT if(A (1?,,dA it BUSMESSIAG1ENCY /Ii <br /> ADDRESS L2 t f 1!�`- v i 122 , 7q5 3 <br /> 1 . <br /> PHONE �rC2-2-� FACSIMILE- <br /> 4a <br /> 4- <br /> TIME <br /> TENTATIVE`.APPOINTMIENT DATE <1 4 <br /> (PI se lv o t0 pu s days data PpacstIsubmbEa9 <br /> e uss DAYS <br /> CHECK 8QX TO <br /> EXPE[SETE REQlI�69A0� -RE4UE <br /> st <br /> CA:E � us <br /> SIGNATURE OF APPLICANT � ' DATE � � O�• T <br /> FILE AODRE:SS THis SIDE FHD STAFF.USE ONLY <br /> PROGRAM ELEMENTS SEARCH- <br /> a J CAqj <br /> L L ted Lu <br /> _ t <br /> L=L== <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> 03 <br /> C3 HOUSING A13ATEMENT W58L1D WASTE FACILITY <br /> a UNDERGROUND TANK NSTI CLEANUP SITE ILOPI ❑ FOOD FACILITY Q SOLID WASTE VEHICLE <br /> 0 OTHEcR CLEANUP SITE(NON-LOP' Q DOG KENNEL O DAIRY <br /> 0 UNDERGROUND TANK(MONITORING IR IMOVALI D Ct1G KE RANCYt RP PKG TRlrAE 1AENt PLANT <br /> Ca HA2AR000S WASTE GENERATOR N10TEL1HOTEL 0 PUMPER TpUCVJYAROICH>wM TOILETS <br /> ITES <br /> V I%REiD PERMITTED FACILITY ❑ pOOLISPA (B LAND USE APPI;SPECIFY <br /> ABO <br /> E3 TATTOOI80DY PEiRCMG ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPfiCIFY ASOVEI' <br /> CI MED1CALWASTEFACILrTY <br /> q, List up to ten addresses in the$!ono Tile vtypo MUST be type(5) <br /> e eested{Fsax t From <br /> 209 464-0138 orbm it to the <br /> 9 <br /> the appropriate bOX(Os). At <br /> address indicated above. <br /> 2, EMD will notify the applicant if any EHD rites exist.' An appointment for review will be confirmed <br /> approximately five business mum of five buss elater <br /> s dgys than <br /> n(10)days after re-ceipt of eview. Appointments 9houldplication. The be hedued <br /> f les <br /> will be held for a maximum <br /> accordingly. C Staff may not be immediately available for roview. A new <br /> 3. A ilia that is actively being worked°n by� y <br /> application may be submitted when the file is available. at the expense <br /> lt be reorganized by ER <br /> 4. Any file not relu Fud'n'ehie rer+'�ews by tame che same appandition as licant released nit may require a smoo d pos prior to review. <br /> of the applicant <br /> g, <br /> *TENTATIVE appointment dates must 6e confirmed with EHD staff. <br /> 6. Appllrations received after 3:00 pm wit!be processed the next business day. <br /> • rD <br /> RMED APPOINTMENT GA'CE, <br /> TIME <br /> PHONE FAX INITIALS <br /> ONFIRMED <br /> EDYESNO REVIEW DATE- <br />