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,in 20 03 09: 19a Mellisa Kim 818-'1�13­894 p. 2 <br /> IL <br /> rHe Loo nueern <br /> u Il,'I SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL 4,IEALTH DEPARTMENT <br /> JUN 2, O 2()03 304 EAST WEBER AVENUE,THIRD FLOOR I / <br /> STOCKI'ON CA 95202 <br /> -�.I�IIf;OP16�E.p1 iiL6834 <br /> w I(i (209;,420 <br /> :.,,T ;FFt dICES PUBLIC <br /> CRECORDS RELEASE APPLICATION <br /> ! + � t ` . M L At0�-I1C <br /> APPLICANTeUSINESSIAGENCY � z � xn_ <br /> ADDRESS_IC)gH L\u1E -r Ave Cnf!� (WAA . <br /> -yI'f/1��V1Y--1. v`n- _��__-- �(� n l/ <br /> PHONE.-i.,J-LI �O '"I`I ' 1 FACSIMILE:_() IB '•J lS� :7 -LI J� _—_.— &/'"tv�/ <br /> TENTATIVE'APPOINTMENT DATE _ TIME <br /> (Please give 7 to 1D business d rys from date of applioaeon aubmilteq <br /> o � <br /> CHECK BOX TO EXPEDITE REQUEST-$89.00 FEE-REQUEST PROC)ESSED IN]BUSINESS DA/SI� <br /> SIGNATURE OF APPLICANT UATE•.`e�_=_t <br /> THIS SIDE THD ST/.FF USE ONLY <br /> FILE ADDRESS PROGRAIIELEME NTS SEARCH <br /> naf VC f Nis) 05!vu <br /> p <br /> W Cherie �� -- <br /> q521071 <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> (UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT O SOLID WAST R FACIL.rrY <br /> OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY 0 SOLID WASI E ValICLE <br /> aQ UNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG h'.ENNEL 0 DAIRY <br /> 0 HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 17 PKQ TI'.EATI IENT P LANT <br /> 0 TIERED P€RMITTED FACILITY 0 MOTEIJHOTEL 0 PUINPE(R TRI CKPfARDICHEM TOILETS <br /> 0 TATTOOIBODY PEIRCING 0 POOLISPA 0 LAPID USE APPLICATION SITES <br /> O MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY)—_ <br /> 1 <br /> PECIFY) _._1. List up to ten addresses in the space above. Select the type(s)of files f•orll the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax WX. !i4xi l or maI1jQjhQ <br /> address Indicated above. <br /> 2. EHD will notify the applicant If any EHD filer exist. An appointment for review(rill be confirmed <br /> approximately five business days but no lalLr than ten(10)days after receipt of application. The files <br /> will be held for a maximum of five business days for review. Appointmant.�shruld be schedul�ad <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be Immediately ava liable for review. A now <br /> application may be submitted when the file Is available. <br /> 4. Any file not returned in the same condition as released will be reorgani::ed by I:HD stuff at the expense <br /> of the applicant. Future file reviews by the:tame applicant may require it$89.011 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be cc nfirmed 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 /> mo u.0mi <br /> H�� <br />