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LHU LUU NUMBtH <br /> UHIL M1LIL. <br /> E PSAN JOAQUIN COUNTY AN <br /> RONMENTAL HEALTH DEPARTMENT <br /> 304 EAST WEBER AVENUE,THIRD FLOOR 56)STOCKTON CA 95202 I <br /> (209) 468-3420 <br /> PUBLIC RECORDS RELEASEE-APPLICATION <br /> BUSINESSIAGENCY 1 •"/T'� <br /> APPLICANT C nnnn q <br /> ADDRESS 2 Olt, l:5 Z <br /> -0 +64 <br /> PHONE - 1 �Fj /T�� S� FACSIMILE 9i6 I �O 'Fo 4 _ <br /> TENTATIVE'APPOINTMENT DATE TIME <br /> (Please give 7 to 10 business days from date of application submittal) /, <br /> CHECK BOX TO EXPEDITE REQUEST-$89.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS ' ���, <br /> SIGNATURE OF APPLICANT ze:. DATE <br /> THIS SIDE EHD STAFF USE ONLY <br /> FILE ADDRESS PROGRAM ELEMENTS SEARCH <br /> � O rL�- 7 NG[.Q!✓L Iry U lE <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> 9NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT O SOLID WASTE FACILITY <br /> ,OTHER CLEANUP SITE(NON-LOP) Cl FOOD FACILITY O SOLID WASTE VEHICLE <br /> 13 DOG KENNEL 0 DAIRY <br /> REDDOUS WASTE <br /> FACT ETA TO(MONITORIRNGIREMOVAL) ❑O CHICKMOTEEN RAN <br /> ❑ PKMPERTREATMENT <br /> PLANTHEM TOILETS <br /> Cr C]Z�VNDERGROUND TANK TTATTOOIBODY PEIRCING ❑�POOUSPA LAND USE APPL[CATIO SITES <br /> ❑ MEDICAL WASTE FACILITY OTHER(PLEASE SPECIFY)yy,('��T�� L �'tI S � �� •� <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 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 /> 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 <br /> ar <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EHD 48-02-006 <br /> 0126/2000 <br />