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Received Feb-02-01 08:49am from CCITT 63 y PIERS Env mental page 1 <br /> 02-02-2001 08:5epm FRA Til 14085360294 P.01 <br /> ..:.hL{iplVl,y, L„Y4W rWVUU1( - <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> �� (7 <br /> ENVrRONNIENTAL HEALTH DIVISIQN Z <br /> 00 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> t.2091460-3420 <br /> `l {PUBLIC RECORDS RELEASE APPLICATION <br /> APPUCANT D'XwAT BUS:4E5S/AOCNCY PIMS ENV`L-• tC'S . <br /> ADDRESS <br /> tt��[3730 3At' NNL, 'Rr SrlN �5 , Cl/��� g 51'2. <br /> PHONE=l`-' U• �S�• `T�U U FAt SIMILE409- 3 0--2 <br /> TENTATIVE'APPOINTMENT DATE 'L `10 6U%' ilii✓$ TAA AIS Wpke� <br /> tPlscsa el✓Y rto 1Q ELLb'.11ose day0 from date oTappi l Cation <br /> rT5 -3,, `fI <br /> CHECit BOX TO ExPECRE fiEgUESi• B� E £57 FROCESSfcD tN a'SV$INE93 GAYS <br /> SIGNATURE OFAPPLICAN!T DATE C1•�I-oI <br /> FILE ADDRESS THL4 SIDE KHD STAFF U96 ONLY <br /> PROGRAM ELEMENTS SFAftCH <br /> 90 <br /> N. 1, At 5 MAhTrE CA O <br /> N <br /> co <br /> / E NVIRONM ENTAL HEALTH DIVISION F1LISS <br /> t9 UNDPRGROUND TANK(UST)CLEANUP SITE(LOP) O HOU307 ASATEMENT n SOLID WAS"I'd FAOILITY <br /> ❑rbTN4R CLEANUP SITE-(N0N-LOP( C; FOOO FACILITY r] SOLID WASTE VEHICLE <br /> B` UNCIAOROUND TANK(MONITORINGfREMOVALI ❑ DOO KENNEL C DAIRY <br /> C�HAZARDOUS WASTE GENERATOR C CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PtRmr=u FAowTY C1 MOTEIJMOTEL O PUMPERTRUCKrYARDICHEM TOILE73 <br /> I] TATTOOrRooY priRCiNG t7 POOLISPA ❑ LAND V3E APPLICATION SJTES <br /> 4 MEWCALWASTE FACILITY ❑ PU8LICWA1ERaYSTeM ❑ OTHER(PLEASa SPEOFY ABOVE) <br /> 1. List up to tan addresses in the space above. $olect the types) of flw9 from the list above by checking <br /> the appropriate box(e s). At least one file type MUST ba selected. Fax to(Z99) 464.01"or mail to fha <br /> adjlmu Indicated 11bove , <br /> 2. EMD will notify the applicant If any EHID files exist. An appolntmant for review will be confirmed <br /> approximately five business days but no later than ten(10)day&after raeoipt of 0pp%atlon. The fifes <br /> will be hold for a maximum of five bus;ness days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. AMA that is 20tively being worked or,by MHO staff may not b0 immediately aYaflable for review. A now <br /> application may be Submitted when the We is available. <br /> 4. Any file not returned In the samo condition as rcleased will be reOrgsn Red by EHO staff at the expanse <br /> of the applicant. Fut[ra file reviews by the same applicant may require a$87.00 deposit prior to review. <br /> 6- "TENTATIVE appointment dares must be confirmed with EMD staff. <br /> 6. Appiitations received-after 3:00 pm will be prodesaod the next business day. <br /> ' CONFIRMED APPOINTMENT DATE TIME <br /> RATE CONFIRMED PHONE PAX INITIAL& <br /> Ri;VIEV4ED YES NO REVIEW DATE <br /> 1� e�pra <br /> TOTFL P.01 <br />