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116_ AGE STDCKTDN PAGE e1/01 <br /> 04x07/20 ( 4�. I E00 Lor,NuNasn <br /> RIC— (rc L[ j 0, ,UIN COUNTYPUBLIC HEALTH SEs'ICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> APR n 7 2003 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> ENVIRONMENT HEALTH (209)466-3420 1 3C <br /> PERMIT/SERVI6UBLIC RECORDS RELEASE APPLICATION <br /> �/� <br /> APPLICANT ` BUSINESS/AGENCY L�V _4 6A"M � <br /> ADDRESS ^^A (� AOU) d ea 9 s- ,. <br /> PHONE CptV7 7 U! ( ' 106� /�F�ACSIMILE ��AQ�Q/�j1 7� � (•,� i- <br /> TENTATIVE-APPOINTMENT DATE'� 0111 WIkOA- �CJ.�//�f � TIME — _ �-lD-�'� <br /> (Maass give 7 10 10 business days from data plication submittal) • F, <br /> CHECK BOX TO EXPEDITE REQU7•se{.00 FEE—REQUESTPROCESSED IN 3 BUSINESS DAYS ' " <br /> SIGNATURE OF APPLICANT DATE <br /> FILE ADDRESS <br /> v t de <br /> LI <br /> CFj Le-�k o .1 <br /> D - ` <br /> ENVIRONMENTAL HEALTH DIVISION FILE APR 10 2003 W <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY N <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGlREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PI(G TREATMI?NT PLANT <br /> 10 TIERED PERMITTED FACILITY ❑ MOYELlHOTEL ❑ PUMPER TRUCK/YARD/CHEM TOILETS <br /> O TATTOOIBODY PEIRCING ❑ POOLISPA ❑ LAND USE AP9LICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ PVBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses 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 to (209 464.0138 or mail 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 worked on by EHD staff may 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 $78.00 daposit 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 clay. us— <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> 1111 00 14 01roeroo — <br />