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\ 06/05/2003 11:41 2094671118 AGE STOCKTON PAGE 191./01 <br /> v DATE PECMN D Edo LOO NO"tA <br /> SAN JOAC,lU1N COUNTY <br /> D E��(rC_,!!\.���11t-�,1 �i <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 EAST WEF AVENUE,THIRD FLOOR STOCKCKT'DN Cq 95202 <br /> JUN0 5 2003 (209)468-3420 1390 <br /> PUBLIC RECORDS RELEASE APPLICKrmi <br /> p� r11TF>>E s dcr<rnced Gee'! ur�rmIt�l►�i <br /> A ORES57 n Pte/ JC/•pU51NE551f10ENCY T- -- <br /> uJ / CSA <br /> PHONE aa4. y&T[/Oa(C1 FACSIMILE aoQ. y� �• �� __..___._ <br /> /�/� - ear�r <br /> TENTATIVE*APPOINTMEN7DATE &&01123- -`�lJes TIME �IC/1/ __.�.._._ /5 am.". <br /> (Pt9wa glvo 7 to 10 business deys from tlata of plicatlon submlltal I <br /> r�eat�y . 'Thr;►tYe <br /> CHECK BOX TO EXPEDITE REOUE - 9.o0 FEE–P.EOUEE 7 ROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT M!�'`�� ( jr —_-!)A713�e_G��II U <br /> FILE ADDRESS THIS SIDE END ST qFF US O <br /> PROGRAM F:LE]PINTTi SF <br /> r <br /> se St es - _ — - -- -- <br /> ENVIRONMENTAL F EALTH DIVISION FILES <br /> GY DNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSIN-3.ABATEMENT v SOLID WAS"E FAC;LITY <br /> Q/0THER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY M SOI.IO'NA1–E VICHIOLE <br /> D/�yN DERGROUNO TANK(MONITORING/REMOVAL) ❑ DOG KEVNEL C] DAIRY <br /> O/HA7ARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TIZEAVAENT F'LANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELII IOTEL Cl PUMPER TFI ICKIYARDICHEM'TOILETS <br /> ❑ TATTOOIBOOY PEIRCING ❑ PCOLISPA - Cl LAD:O I1SE A PPLICATION SITES <br /> M MEDICAL WASTE FACILITY Cl OTHER(PLE:ASE SPECIFY) <br /> 1. List up to ten addresses in the space above. Select the type(s) of files fnorn th,; list:above by Checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax tc.LOPh!:&l_0?18 or mai I to the <br /> address indicated above. <br /> 2. EHD will notify the applicant if any EHD files exist. An appointment for navlew ntlll be confirmed <br /> approximately five business days but no later than ten(10)days after receipt a4'application. 1he.files <br /> will be held for a maximum of five business drys for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that Is actively being worked on by EHU staff may not be immediately aw ilable for review. A new <br /> application may be submitted when the flie is available. <br /> 4. Any file not returned in the same condition a; released will be reorganized by C'HD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require it $09.011 deposit prior to review. <br /> 6. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> S. Applications received after 3:00 pm will be prxessed the next business duy. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PRONE FAX INIT64I-S <br /> REVIEWED YES NO REVIEW DATE =_ <br /> EMD 4B-0L00E <br /> Y2613u0J <br />