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v3/0/2003 12:00 FAX 208 948062J f <br /> {� > <br /> X002%002 <br /> E1110 LOG IUfYBFR <br /> SAN JOAQOIN COUNTYPUBLIC HEALTH SER ES <br /> �- - ENVIRONMENTAL HEALTH DIVISION <br /> MAR 1 9 2003 304 EAST WEBER AVENUE,THIRD FLOOR jq6. <br /> STOCKTON CA 95202 <br /> ENVIRONMENT FfEALTH (209)4e3-420 <br /> PUBLIC RECORDS RELEASE APPLICATION 4 <br /> r <br /> APPUCANT, V. _•••` �j t i; F;_S ^aUSINEWIAGENCY <br /> ADDRESS '` <br /> ��d S' <br /> PHONEr'LO9-^ wISS �_ FACS11WULE «R46-DbZ l <br /> TENTA7IVF-*APPOINTMENTDATE 3 i-4.)LO 3 _ TIME <br /> (Please Ohre 7 to 10 business days from date of application bubmtttal) _ <br /> CHECK BOX TO EXPEDITI=REQUEST-$87.00 -REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> � TPI: � a <br /> SIGNATURE OF APPLICANT DATE _5 1 `3 D , <br /> FILE ADDRESS THIS SIDE END STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> c • U .tea _ <br /> r•� , 1.8u+ sF A+4~ l_twl^jP CA <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) D HOUSING ABATEMENT I$ SOLID WASTE F.ACIUTY <br /> OTHER CLEANUP SITE(NON-LOP) O FOOD FACILITY )V SOLID IMAM VEHICLE <br /> UNDERGROUND TANK(MONITORINGWEMOVAL) O DOG KENNEL 1E DAIRY <br /> 1% HAZARDOUS WASTE GEriERATOR d CHICKEN RANCH PKG Tri ATM EN PLANT <br /> -nERED PERMITTED FACILITY I7 MOTELIHOT)EL •:• 10•PUMPER TRUCk7YARINCHEM TOILET5. <br /> U TATTOOIBDDY PEIRCING O•P � <br /> OOUSPA '' .LAND USE APPLICATION SITES <br /> 0 MEAICAL WASTE FACILITY 9L PUBLIC WATER SYSTEM G MER(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 rile type MUST be selected. Fax to(7_Q91 4644{1138 or mail tv t e <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 laterthan ten(10)days after receipt of application. The files <br /> will be held for a maximum of five business days for review. Appolntments 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 n�lw <br /> appllcatlon may be submitted when the file Is available. I <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD stiff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a$87.04 d+)posit 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 INrnAIJs <br /> REVIEWED YES NO RE P.W DATE _ <br /> ��RR1 <br />