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SAN JOAQUIN COUNTYPUBLIC HEALTH StRV1(:kb <br /> "NVIRONMENTAL HEALTH DIVISIC <br /> '"-304 EAST WEBER AVENUE,THIRD FLOOD w �_ C F <br /> FEB - 5 2001 <br /> STOCKTON CA 95202 0 <br /> (209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> Clrl�r�n�Pd �of�,ry�� ��r t�.rnc. <br /> AF&I17 � �M1e- BUSINESSIAGENCY <br /> °D s Do s L /ho a C'A � Sa0p5— • <br /> PHONE 0?0 vo FACSIMILE /p / //, <br /> )L"Ekt:: 6 2001 <br /> TENTATIVE'APPOINTMENT DATE 4 F.Qh a010a_f_Utu(S)TIME 1fl�00 <br /> ��pJt (Please give 7 to 10 business days from date of appliegtion submittal) <br /> �Pl CHECK BOX TO EXPEDITE REQU T-S14.-W FEE—REQUE i PRO ESSED 1N 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT �� � DATE <br /> FILE ADDRESS <br /> q110 QNuTl, rA W14 <br /> 2 C <br /> r <br /> 49 <br /> N :� IV <br /> CL <br /> 40 <br /> 9 ?nni <br /> y - — 1 <br /> 89 ' <br /> 4V W <br /> ENWRONME AL HEALTH DIVISION FILES <br /> %)1( UNDERGROUND TANK(UST)CLEANUP SITE(LOP) HOUSING ABATEMENT 13SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) FOOD FACILITY ❑ SOLID WASTE VEHICLE f ` <br /> UNDERGROUND TANK(MONIYORINGIREMOVAL) O DOG KENNEL ❑ DAIRY l`/j�' <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ FKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑ TATTOOIBODY PEIRCING O POOUSPA ❑ LAND USE APPLICATION BITES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM [7 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 EMD files exist- An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10) days atter 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 /> S. `TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications recetved 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 OV.&M <br />