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07/08/2002 80N 12;50 FAX 916 5654356 V01/001 <br /> uli nni<ouc tn:vb 4b ENVIROPWENTAL�TH PAGE 01 <br /> JOAQUIN COUNTYPUBLIC HEAL It, SERVICES sntxnuvaen <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOORLOOIk <br /> I / <br /> STOCKTON CA 95202 <br /> (209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT RUSINESS/AGENCY sT&,m.J <br /> ADbREss /32� w� .r,/ '"� <br /> PHONE n9/(�-!,(�5-.�.�< FACSWILE SG- . • .. <br /> Q TENTATIVE'APPOINTMCNT nATE TIME <br /> C, (Plewa Alva T t 1 s s d apple sabmlltal) <br /> I <br /> CHECK BOX TO EXPEDITE REQUEST- eF - E ST ACES ] (NESS PAYS <br /> SIGNNI URE OF APPLICANT DATE <br /> FILE gppRESS THIS SIDE CHO STAFF USE ONLY <br /> \ � D .✓ S2 PLEM <br /> PROGRAM ECNT55EARCH O <br /> AVyL Z_ N <br /> v <br /> Vvv W <br /> tiV <br /> V D li aPj <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> III UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> ❑ OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> ❑ UNDERGROUND TANK(MOWTORNGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> S➢ HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILrrY ❑ MOTELIROTEL ❑ PUMPER TRUCKMARVICRENITOILETS <br /> ❑ TATTOOMODY PEIRCINO ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY . ❑ PUBLIC WATER SYSTEM m OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to tan 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 mall to the <br /> address indicated above. <br /> 2- EHD Will notify the applicant if any END files exist An appointment for review will be confirmed <br /> approXimatefy five business days but no later than ten(10)days after rocelpt of application. The fifes <br /> will be held for a maximum of five businass days for ewiew. Appointments should be scheduled <br /> accordingly. <br /> 3. A filo 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 /> or 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 END 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 IN TIALS <br /> REVIEWCD YES -NO_ — REVIL•LV DAT-E.. ..— <br /> mnumr -- <br /> Post-ie Fax Note 7671 0`t°7 rL wieNa+� <br /> Te From A <br /> CoJDept o °- '-C.O 15 f <br /> Phone♦ Pnano�zGl G b'- Zd <br /> 7. F"s �.05 qo l '00 <br />