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05/01/2003 07:43 7146711008 ESS PAGE 32 <br /> " - O 00,3 1P - 4642113' SAN J0AQUIN trv+.'CiOw.uivr,u.in� iw. s;a,�w.ortieYi <br /> JNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> MAY 0 1 2003 3p4 EAST WEBER AVENUE,THIRD FLOOR r <br /> STOCKY DN CA 95202 "J`►/•J� <br /> FPJNIRiil.u`�9EiV NE 1 T N (209)48 .34 <br /> 820 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> r <br /> ANT Lf yyf� 0 nAaaLICz•t� <br /> ADDIMS5 -: 7 )0 C r . tS�. ! <br /> PHONE ( i� q '_—�'✓'� _tic�-'-..f. <br /> 10� FACALWLE 7 <br /> TENTATIVE*APPOINTMENT DATE — TIME _,—,�,.,,_,___- 5 �3� ✓ �" <br /> (Please give 7 W 10 bualnoee dnys flan date of aapfi4910n submIMPA) <br /> CHECK BOX TO EXPEDITE REQUEST-$09.00 FEE-RE EST PROCESSED IN f tiUSlNI:sS 0.4Y! / <br /> -*SIGNATURE OF APPLICANT �__.. ❑A'f E Z-_5,,,;�'U,j <br /> FILE ADDRESSL)PRVT,'. <br /> '171-uitE ONLY �I <br /> PI2pGRIW ELEl11EN1'E�IaARCH rr <br /> 0 r A — -- — —�— 1 <br /> DO {r _ <br /> Q P <br /> J/ <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> -)i uNDEROROUND TANK(U51)CLLIWUP ME(LOP) 0 HOUSING ABATEMINT 0 60LIDwAI•Tik PIVNLITY <br /> CUIPRED <br /> THER CUANUP SITE(NON-LOP) 0 FOOD fACILITY 17 MILK)WA!•TU VrMICLI: <br /> NbgROROUND TANK(LtONRORINGMEMOVAU O DOe Kf_NNEL t7 Diowr <br /> AZARDOUS WASTE OENERATOR 13CHICKrN RANCH 0 P} 'r RTX7MaNT PLANT <br /> PERMMED FACILITY 0 MOTEL/HOTML O FLYNr'MR TItUCX/YAADlCNanl TOILE M <br /> O TATTOOIBODYPEIRCING 0 FOOV£PA 0 Ud40 Uas AMILICATION errYe <br /> 0 MMCAL WARTH FACILRY n OTHER(PLKASE SPECIFY)__—, <br /> 1. List up to ten addresses in the space above. Select the type(s) of Ries from tho Ilnt above by checking <br /> the appropriate box(es). At least one file type MUST be selected. EMU <br /> address indicated above, <br /> 2. EHD will notify the applicant If any EHD files exist. An appointment for revlevi will b,e confirmed <br /> approximately five business days but no later than ton (10) days after rlrmulpt of application, Tba file-9. <br /> will be hold for a maxlmum of five business days for review. Appointmen(M ehouid tai schodubed <br /> accordingly. <br /> 3. A file that is actively being worked on by CMD staff may not be immedliftaly aYailable foe review. A now <br /> application may be submitted when the file is available. <br /> 4. Any fib not returned In the same condition as released will be reorganh:ed by I:HD otaff at the acpenmb <br /> of the applicant. Future file reviews by the rime applicant may require a.U9.00 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 buelneslt day. <br /> CONFIRMED APPOINTMENT DATE ___ TIME <br /> I <br /> DATECONFrl2ME0 PHONE FAX IpRIAJL�I <br /> j REVIEWED YES NO ^ REVIEW DATE <br /> .vzvrso� <br />