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07/17/03 10:18 FAX 219 630 7070 HBC ENGINEERING 1001 <br /> DATE Me d ail ' , I ` _ j�"; EADL.00NUMER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT 2 <br /> JUL 1 % ";I.I()3 304 EAST WEBER AVENUE,THIRD FLOOR J <br /> STOCKTON CA 95202 <br /> � FdVli _i";IilAcldl {� �vLill (209)468-3420 <br /> ni ?,: A/ CPUIBLIC RECORDS RELEASE APPLIICpA�TION <br /> APPLICANT <br /> rr��F��k=1U/.�C, C�".±- LL~�I/Y pc cB�U�S�INESSIAGENCY�I �-y (� <br /> ADDRESS�rS-ICiI -1-SK.1'z.N�� 1� I`gc� �f 4SS( IO61 bAL jot4'3 (:7a lr7 <br /> PHONES-L FACSIMILE 62 N (O'C>— '(C' 7L� <br /> TENTATIVE'APPOINTMENT DATE ~I al b3 TIME <br /> (Please give 7 ro 70 business tlays frog dake of appli=lon submitral) <br /> CHECK BOX TO EXPEDITE REQU.�T-$59.00 FEE-REQUES PROCES5ED IN 3 BUSINESS DAYS U 1 \\\ <br /> SIGNATURE OF APPLICANT DATE t171 O <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> _ PROGRAM ELEMENTS SEARCH v <br /> y Y r <br /> Io I k-(t4X25 N� • W <br /> 2burF> P�RS+�I n�Com_ on <br /> J V�1 <br /> 11ji NPV y '�- C LLQI <br /> �I ZllO v Xf. s <br /> IMMIN.11le LIP 11 <br /> r.� <br /> `V1/vJ� <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) El FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) CI DOG KENNEL O DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> ❑ nEREO PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARDICHEM TOILETS <br /> El TATTOOIBODY FORCING ❑ POOUSPA ID LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <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$89.00 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 INmALS . <br /> REVIEWED YES NO REVIEW DATE <br /> ENO ae-.- <br /> vw=aea <br />