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UATt RECEIVED CHO LOU NUMBER <br /> '7' _ANJOkIN COUNTYPUBLIC HEALTH SER FS <br /> il fi <br /> Ei—)RONMENTAL HEALTH D N'1510N <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> APR 0 3 2003 STOCKTON CA 95202 <br /> (209)468-3420 <br /> I-AVEONMENIA',EPUBLIC RECORDS RELEASE AF'PLICATION <br /> APPLICANTBUSINES$IAGENCY qPE1.) <br /> 5 <br /> ADDRESS 225- <br /> PHONL -FACS'IMILE <br /> TENTATIVE"APPOINTMENT DATE TIME _-IR22AVY1 <br /> (Please give 7 to 10 business daystramdate otapplNotlon Subml%21) <br /> HECK BOX TO EXPEDIT"REQUEST-$99.00 FEE-REQUEST PROCESSED I 7 101.15INES5 DAYS W1 <br /> I SIGNATURE OF APPLICANT -C> <br /> !ILE ADDRESS 'eHI3 SIDE EHP STAFF USE ONLY <br /> PROGRAM ELEMENTS SEoIRCH <br /> Al RDIFLA & AI I <br /> '4? <br /> OLL S I t <br /> L <br /> 22 <br /> eA- <br /> wu%r Urn-', <br /> _/hZ Z' <br /> ✓ rk <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK JUS--)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT 0 SOLII)wASTS FACILITY <br /> 0 OTHER CLEANUP SITE(NO 4-LOP) 0 FOOD FACILITY a SOLID WASTE VEHICILIE <br /> A16 UNDERGROUND TANK(Ro 41TORINGIREMOVAL) 0 DOG KENNEL 0 DAIRY <br /> IMAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> CJ TiEREOPERMITWI)FACILITY 0 MOTF.WHOTEL 0 pumPERTRUCWYARDICHEM TWLETS <br /> 0 TATTOOA30DY PEIRCINC 0 POOL/SPA - 0 LAMP USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY 0 1ll1l0l1l It 0 oTTiEft(PLEASE 9.IJ F-CIPY ABOVE) <br /> I List up to ten addresses in the spare above. Select the ty De(s I of files frCM the list above by checking <br /> the appropriate box(es). At least one file type MUST be selec-tiod. Fox to(209)464!-0133 or mall to the <br /> address Indicated above. <br /> 2. END will notify :he applicant if any EHD files exist. An ap, ohrment for review will be confirmed <br /> approximately live business days but no later than ten('JCI)days after receipt of application. The flies <br /> will be hold for a maximum of five business days for Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is acilvety being worked an by EHD staff may not tro,Immediately available" <br /> application may be submitted when the file is available. <br /> 4. Any File not returned In the same condition as released wail be reorganized by EI-IDstso7t LIS H <br /> of the applicani. Future rile reviews by the same applicant May require a$89.00 deposit prior to review. <br /> 5. 'TENTATIVE aFpotntment dates must be confirmed with 4HCI otaff. <br /> 6. Applications reze.ived after 3:00 pm will be processed the next:business day. _C0P=y <br /> CONFIRMED APPOIN"'MENT DATE TIME <br /> DATF_CONFIRMED PHONE FAX INITIALS <br /> REVIEWED y I---S NO REV( W DATE <br /> as <br /> 041 3/03 THtf 13.20 ITX/RX NO 96021 W002 <br />