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07/10/Do hI\oN 16:10 FAX 102��:}a2.0 <br /> 11bG 1:IY' 2 P.02 �tf it ll r: <br /> 1"?0?46' <br /> SAN JOAQUIN COUNTYPUSLIC HEALTH SERVICES EH6U7GM1M6Fh <br /> ENVIRONMENTAL HEALTH DIVISION <br /> AUG 2 9 ZOOO 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> ENVIRONMENT HEALTH (209)468-3420 <br /> ,�pFRMIT/ RVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLIjkA <br /> RUSINESSIAGENCY <br /> C <br /> V FACSIMil-E I <br /> 1-1=N FATIVE'APPO1NT6riENT DATE TIME <br /> (Plea"Give 7 to 70 1-.; as d+rya from stain-i applI submittal? <br /> CHECK BOX TO EXPEDITE REQUL.s -STI W -RE EST PROGESSED IN 3 BusivessvAYS <br /> SIGNATURE OF APPL3CANT DATE <br /> FILE ApARESs <br /> 2 <br /> n -7 171. '_1 S S<< <br /> - - <br /> ( /'' I/ 2� ' <br /> 17 <br /> ;L <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LAP) O HOU31HO ABATEMENT �11 503-ID WASTE FACILITY <br /> OTHER CLEANUP SITF,(NON-Loi') d ROOD FACILITY b SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONiTOR1NGIREMOVAL) CI DOG KENNEL DAIRY <br /> )91 HAZARDOUS WASTE GENERATOR ❑ CNCKE?1 RANCH PKG TREATMENT PLANT <br /> �I TIERED PERMITTED 12ACILITY ❑ MOTELI"DTEL PUMPfiR TRUCK/YARMCHEY TOILETS <br /> ❑ TATTOO/SoDY PEIRCIwG ❑ POOLI9PA LAND Use APPLICATION 3ffEn <br /> C7 ML04CAL WASTE FACA.ITY ❑ PUBLIC WATER SYSTEM El CITIHM- (PLEASE SPECIFY ABOVEI <br /> i- List up to ten addrlesses in the spa6ft above. SeloCt the type(S)Of'file9 from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selacted. Fax to(200)464-01 8 or mglil to the 4-- <br /> addra§s fnd4f,�Ited abQy® <br /> 2. EHD will notify the ,applicant if any FHD Files exist. An appalntMent for ruviaw will be confirmed <br /> approximately five business days but no later than ten(10)days after receipt of application. The flies <br /> Will 1>e 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 retumea in the same condition as released will be raorganizcd by EHD Staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require in$78-00 deposit prior to review_ <br /> 5- "TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 prn will be processed the next business day. <br /> CONFIRMED APPOINTMENT DACE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> GK as 14 of — -- .- <br /> TOTRL P.r2 <br />