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JUL-11-Ud M1 U1 ;59 PM SAIC -.,SACRAMENTO FAX N0, 916 97j.8830 P, 02 <br /> •;�oA7i:RecErveo ���� , �� i •�/ <br /> SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> JUL Z003 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 EAST WEBER AVENUE,THIRD FLOOR jr <br /> 1'i i Lf1LTH STOCKTON CA 95202 <br /> PF �p,'1:i r'.`-;s"(;'v/1CF-S (209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT �d1� �l l BUSINESS/AGENCY <br /> ADDRESS / fk2oi9 t!'��, <br /> PHONEC:ln/G) 9W--3W/ FACSIMILE Cylt0� 9 <br /> TENTATIVE*APPOINTMENT DATE TIME <br /> (Please give 7 to 10 business days from date of application submittal) <br /> 2 CHECK BOX TO EXPEDITE REQUEST-$89.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS �J <br /> SIGNATURE OF APPLICANT DATE <br /> DDRE THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> a8 <br /> %i <br /> 3 <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> ❑}KDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> IN OT14ER CCFANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> O UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL 0 DAIRY <br /> ❑ HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> O TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCK/YARD/CHEM TOILETS <br /> I] TATTOOIBODY PEIRCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <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 END 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 reviews by the same applicant may require a$89.00 deposit prior to review. <br /> S. *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 /> ENP 4"Z-906 <br /> �ttilYoo3 <br />