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_ 10/15/2002 06:18 707452841•_ JEAN HUGHES PAGE 01 <br /> v MTa MC - - ..-- — moI,00NIAam <br /> SAN JOAQUIN COUNTYPUBLIC HEALTHSERVICE <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 1jV �Mu 304 EAST WEBER AVENUE,THIRD FLOOR <br /> N4WCA <br /> 420202 <br /> PUBLIC RECORDS RELEASE APPLICAT104" 1 5 ZOOZ <br /> l r , <br /> APPLICANT RUAIMEMAO INCY Q _ <br /> ADDRESS <br /> D D.0 1 <br /> PHONE FA^^CnnSIMILE `y <br /> TENTATIVE*APPOINTMENTDATE, 114/I/� (� (� TIME �� 4 <br /> (FINN QW.I tO 1�'bmlne"�A <br /> / N Of�ldtivn.ubTltfil) r,r` �a <br /> /V,/CHECK BOX TO EXPEDITE REGUES -{89.00 FEE-REQUROC E 1 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT A AA I NOA DATE <br /> FILE ADDRESS TH13 SIDE END STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> N <br /> o <br /> N <br /> ENVIRONMENTAL HEALTH DIVISION FILES OCT 17 2002 <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSINO ABATEMENT 0 SOLID WASTE FACILITY <br /> 4.01'HER CLEANUP SITE(NON-LOP) ❑ FOOD FArRAT I7 SOLID WASTE VEHICLE <br /> E`UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> )'HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH O PKG TREATMENT PLANT <br /> ❑ TWRED PERMITTED FACILITY ❑ MOTELMOTEL 0 PUMPER TRUCK/YARDICHEM TOILETS <br /> 0 TATTOOIBODY PEIRCING 0 POOLWA ❑ LAND USE APPLICATION SITES <br /> O MEDICAL WASTE FACILITY PUBLIC WATER SYSTEM? ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to tan addresses In the space above. Select the type(sl of files from the list above by checking <br /> the appropriate box(as). At least one file type MUST bs selected. Fox to (209)464.0138 or mall to the <br /> address Indicated 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 ten (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 worsted 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 returned In the same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant Future file revlews by the same applicant may require a $09.00 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 /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> r <br />