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Jul 24 03 02: 46p P. 1 <br /> 07/24/2003 14:31 4640138 ENVIRONMENTAL HEALTH PAGE 01 <br /> d. LuGrvuuucu <br /> ff SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> CA <br /> JUl- 2 4 2003 STOCKTON(209)468-3420202 I <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> Vi,.,.m=u_ , <br /> D�ARP.,IkAN`<I� P.A /A Vt f B.""NESS/IAGENCY I✓L 1 I�G <br /> ADDRESS i \C�c�.t.���/� CiO,.I �- I S i-e ?/�Z 9y.r In i'=4,'A7 I <br /> PHONE�(�SbJ S -( I �'� �� FACSIMILE f OSP)) '�R-9T <br /> — 3-O J <br /> TENTATIVE'APPOINTMENT DATE 'FIZcS �I3a TIME Q <br /> (Plow,give 71e 10Tbucin„s days date of app11w0an submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-S99.00 FEE-REOUEST PROCESSED IN 3 BUSINESS DAYS ' <br /> SIGNATURE OF APPLICANT 0 I :1, x�C DATE Z <br /> FILEADDRESS THIS SIDE EHD STAFF USE ONL <br /> 1PROGRAM ELEMENTS SEARCH <br /> S . T <br /> L c ' -i L -- r . <br /> C <br /> f 1'23 L rn LU S 0 <br /> v ( , w LUSI VJ <br /> nn T <br /> MI 1 11 Irlul <br /> ENVIRONMENTAL HEALTH DIVISION FILES Vw <br /> *UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT <SOLID WASTE FACILITY <br /> y.�OTHER CLEANUP SITE(NON-LOP) O FOOD FACILITY SOLID WASTE VEHICLE <br /> ;1 UNDERGROUND TANK(MONITORING/REMOVAL) C DOG KENNEL 0 DAIRY <br /> HAZARDOUS WASTE GENERATOR O CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> C TIERED PERMITTED FACILITY 0 MOTEUHOTEL 0 PUMPER TRUCK/YARD/CHEM TOILETS <br /> 0 TATTOO/000Y PEIRCING C POOUSPA /Im LAND USE APPLICATION STIES <br /> C MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> 1. List up to ten addresses in the space above. Select the typa(s)of files from the list above by Checking <br /> the appropriate box(es). At least one file type MUST be selected. FFjx 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 toe 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$69.00 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 /> .0.... <br /> )f1N0,] <br />