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Mar . 31 . 2003 5 :33PM COW. EARTH TECHNOLOGIES � No. i21y P 1/1 <br /> �r'{}r!I_„ii=,ll`,��I'=, Q SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> APR 0 1 .2.003 304 EAST WEBER AVENUE,THIRD FLOOR ^ <br /> STOCKTON CA 95202 <br /> 04VIR:dNi'di:iJl iTEALTH (209)46Z-3420 <br /> P6tiMmT ERVIUS PUBLIC RECORDS RELEASE APPLICATION <br /> T <br /> APPLICANT-- <br /> PPLICANT_ ` �^�BUSINESS/AGENC <br /> Y <br /> ADDRESS IUCJ SJL�� ��,5'T I tom_ 3 '72�1I � L J���,_ <br /> PHONE — FAcswLE <br /> TENTATIVE*APPOwTMENTDATE 1161E ______ - G �3(7d000(((y�SS� <br /> (Please ova 7 to in 6usinC4 days flan date of application subrtlntal) �� �, �\� <br /> CHECK BOX TO EXPEDITE REQUEST-$87.00 FEE—REQUEST PROCESSED IN 3 BTTSINESS DAYS U� p <br /> SIGNATURE OF APPLICANT �i -�� DATE Z t cls D � <br /> FILE ADDRESSi1TIS Sit)E i:HD sTAJF,F USE ONLY aw <br /> PROGRAM ELEMEtITS SEARCH <br /> io/3 S• r0// <br /> t <br /> 5 - <br /> zS*ect x ja. 1 - <br /> -7 _ <br /> `1Y60 it. �• .T - ....,_ <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT p�sOUD WASTE FAcL�rx, <br /> OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY SOLID WASTE vEHI � <br /> J2%' UNDERGROUND TANK(MONUORING/REMOVAL) O DCG KENNET. ❑ AIRY <br /> 0 HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH �d AKG TREATMENT PLANT <br /> jLrTIER.ED PE"NTED FACILITY d MOTCIJHOTEL ❑ PUMPIERTRUCNY)ARDiCHEMTOII.MZj <br /> ❑ TATTOO/BODYPEIRCMG 0 POOL/SPA "- - ❑ LAND USE APFLXATIONSTYES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTIiF;'t QPLEASF.;PECTFYA©OM <br /> 1• List up to ten addresses in the space above.. Select the type(s) of files from the IN t above by checkfng <br /> the appropriate box(es). At least one file type MUST be selected. Fax tot?O9) 4&L0138 or mail to ttte <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. Appointment:3 should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be Immediately availablo for review. A new <br /> application may be submitted when the hie is available_ <br /> 4. Any file not returned in the same Condition as released will be reorganized by EHD staff at the expenso <br /> of the applicant Future file reviews by the same applicant may require:1 $87.00 deposit prior to reriaw- <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 AAPPOINTMENT DATE TIME <br /> nATF r1.nM=ID11ACi1 <br />