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06/05/2003 11:41 2094671118 DAATTTEEI RELENED ,IJ -1 l_ SIC 1��Ii �J ril JUN 0 5 2003 61, AGE STOCKTON IIAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 EAST WEBER AVENUE, THIRD FLOOR STOCKTON CA 95202 (209)468-3420 PUBLIC RECORDS RELEASE APPLICATION PAGE II1/01 fila Log NUu6EA' i3ao ADDRESS 715 J'l Nf LJLW �17C/IY �. VCUL.(-L C711 J (� �% _ PHONE o769% V& / ,1406 /- FACSIMILE OL7 �' 1 6 I' TENTATIVE* APPOINTMENT DATE � Q 0 — /V� TIME (Nlaase glue 7 to 10 business deya from tlatA o} plioaUon submlftall Tth- i''ec1L�y LP CHECK BOX TO EXPEDITE REQUE 9.00 FEE — SIGNATURE OF APPLICANT IN 3 BUSINESS DAYS 62 THIS SIDE. EUD STI1kFF-=c � GF' UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSIN,3 ABATEMENT CI SOLID WAS- E FACILITY MOTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY Y- �� _ +n ❑ DUG KENNEL mh I Lyl�i CYHATARDOUS WASTE GENERATOR ❑ CHICKEN RANCH I�IIIIII,Y�`I'I�L�[I!I ❑ TIERED PERMITTED FACILITY L�LI Ci PUAIPERTFI!CKIYARDICHEM'rOILETS ❑ TATTOOIBODY FORCING ❑ PCOUSPA - ❑ LAD 0115E A PPUCATION SITES ❑ MEOICAL WASTE FACILITY Cl OTHER (PLEASE SPECIFY) -- ENVIRONMENTAL F• E:ALTH DIVISION FILETS � GF' UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSIN,3 ABATEMENT CI SOLID WAS- E FACILITY MOTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY 0 SOLID WA3"E VEHICLE CrJ}NDERGROUND TANK (MONITOFONGIREMOVAL) ❑ DUG KENNEL ❑ DAIRY CYHATARDOUS WASTE GENERATOR ❑ CHICKEN RANCH CI PKG TREAIIAENT PLANT ❑ TIERED PERMITTED FACILITY Cl MOTEL/I IOTEL Ci PUAIPERTFI!CKIYARDICHEM'rOILETS ❑ TATTOOIBODY FORCING ❑ PCOUSPA - ❑ LAD 0115E A PPUCATION SITES ❑ MEOICAL WASTE FACILITY Cl OTHER (PLEASE SPECIFY) 1. List up to ten addresses in the space above. Select the type(s)of files fnorn thk list abora by checking the appropriate box(es). At least one file type MUST be selected. Fax tc_L0L4:51_013'3 or mail to the address indicated above. 2. EHDwill notify the applicant if any EHD files exist. An appointment for nnviewlvill he confirmed approximately five business days but no later than ten (10) days after receipt of application. Tbe.files will be held for a maximum of five business d:3ys for review. Appointments should be scheduled accordingly. 3. A file that Is actively being worked on by EHD staff may not be immedialtaly available for reviex. A nevr application may be submitted when the file is available. 4. Any file not returned in the same condition as released will be reortlanizod by VHD staff at the expense of the applicant. Future file reviews by the same applicant may require :1$09.011 d2 posit prior to review. 6. 'TENTATIVE appointment dates must be confirmed with EHD staff. e. Applications received after 3:00 pm will be pr3cessed the next business dey. CONFIRMED APPOINTMENT DATE _ DATE CONFIRMED REVIEWED YES NO EHD �e-ciaac Yi61]W� TIME PRONE FAX REVIEW DATE ;a INITIALS