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Jul . 2P �NDOR EARTH TECHNOLOGIES No .0304 P• ' I/I <br /> J once qet, ' • <br /> SAN'JOAQUIN COUNTYPUBLIG HEALTH SERVICES SLOG NWam <br /> )I: ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> 02 JL'L 117 r,l i 8: 1 I (209)46x_3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT Mari It..I[-a,. I q �5 SUSINESSIAGENCY COVL�oY <br /> �ckvLdlo i¢s TKc. <br /> ADDRESS ISS Frank <br /> PHONE 2oq - 23 - o$IB _FACSIMILE 2pq - 23••-( _ 0538 . <br /> zoo -�bI -8682_ <br /> TENTATIVE`APPOINTMENT DATE 7- 141 0 2-- nME • <br /> �ry (Please give 7 t0-0—Wi-11 PSM ��f app on submittal) <br /> u CHECK BOX TO EXPEDITE REQUEST•$87.80REQ ES7 PROCEErIIN 3 B SINt;35 DAYS I <br /> SIGNATURE OF APPLICANT DATE 7� °► 2_ <br /> FILE ADDRESS THIS SU7E EHD$7AEF USE ONLY <br /> \/ PROGRAM ELEMENTS SEARCH <br /> 1foZ ook io(¢ 2oe teL }ate <br /> \�/ /obi Mer ciKo •�'. W. <br /> 3 30 VJ O <br /> zssl A N <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ARATEMENT p SOLID WASTE FACILITY <br /> C3'PTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY p SOLID WASTE VEHICLE <br /> C�31NDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL q DAIRY <br /> C9'FSAyARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> =RED FACILITY C1 MOTELIHOTEL PUMPER TRUCK/YARDICHEM TOILETS <br /> ❑ MEDICALTATTOO/ WASODY E F CI LI ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresse's 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 toFax t��209) 464-013�or mall to the013�or mall to the <br /> aodr�ss indleated aboveindleated above <br /> 2. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than tan(10)days after receipt of application. The files <br /> will be 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 m4.y not be Immediately available for review. A now <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 /> of the applicant. Future file reviews by the same applicant may require a $87.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> C CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br />