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UH I c nc.u.w hllU LUb IVUMytH <br /> SAN JOAQUIN COUNTY <br /> ENIRONMENTAL HEALTH DEPART ANT ^ <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> (209) 468-3420 <br /> PUBLIC RECORDS RELEASE APPLIICATION <br /> APPLICANT ` c BUSINESS/AGENCY 1 b7A-f'- e' M'---�'(p <br /> ADDRESS /� •p ✓ ,( ,� ,(` <br /> PHONE t I C7 /��D S� FACSIMILE 9 )6 / �!""I'Y' O �O 4 ;!s•-_~ -` y '`f' <br /> T_ �i <br /> TENTATIVE*APPOINTMENT DATE TIME <br /> (Please give 7 to 10 business days from date of application submittal) •� /��31 <br /> CHECK BOX TO EXPEDITE REQUEST-$89.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS ' K/ Y <br /> SIGNATURE OF APPLICANT DATE 4b-4- 0 3 <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> O o R-T► t N(:t,,4 JYZ ky6fv u E <br /> Nl LC L N w E2 <br /> 1 r mom. <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> ldJNDERGROUND TANK(UST)CLEANUP SITE(LOP) 13 HOUSING ABATEMENT 1:1 SOLID WASTE FACILITY <br /> �THER CLEANUP SITE(NON-LOP) 13FOOD FACILITY b SOLID WASTE VEHICLE <br /> MNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> K_PAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑ MOTEL/HOTEL ❑ FUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑ TATTOO/BODY PEIRCING ❑�POOUSPA W LAND USE APPLICATIO SITES <br /> ❑ MEDICAL WASTE FACILITY t OTHER(PLEASE SPECIFY)<L_49'1—t L 9-Y§ T- <br /> I <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 /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EMO*6-02-006 <br /> MU2000 <br />