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04/11/2002 07:51 209?*RO837 BAMBAS AND W' `4ETTE PAGE 01/01 <br /> k 04/11/2002 08:50 46 18 ENVIRONMENTAL\'.ALTH / PA 01 <br /> UA '1;u:t�vt:u �� b u.0..w <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SER ICES <br /> i1^ENVIRONMENTAL HEALTH DIVISION <br /> �d4 EAST WEBER AVENUE,THIRD FLOOR <br /> \/ <br /> STOCKTON CA 95202 <br /> O2 IPPR 1 I q� L (209)468-3420 ' <br /> UB�1G RECORDS RELEASE APPLICATION <br /> APPLICANT lL-lam s� DUSINESSIAGENCY <br /> ADOMS 2, Ge r-!►] C*PA-(- uJa. #A 33 STc>�k- N �► S '7 <br /> PHONE 7J + Z a� FACSIMILE 0 <br /> TENTATIVt�'APPOINTMENT DATE <br /> tq 10-1— TIME <br /> (Please ve T o 10 buSin26s da appltC�' submittal) <br /> CI{ECIc 80X TO EXPBAITE REQUEST- 9. 0 —�Q E8 OCE' l�$BU ES5 DAYS - <br /> � It b <br /> SIGNATURE OF APPLICANT .. . � �`� .— DATE <br /> FILE ADDRESS THIS SIDE EHD STA11F USE ONLY <br /> PROGRAM ELSMENTS SEARCH <br /> L(d Fir. r. 55';L4 <br /> U)I LAQAJW <br /> L400 (Q <br /> Fri na27 <br /> 10 G, /►4 <br /> Z/ M�N�L- A✓� . <br /> E=NVIRONMENTAL HEALTH DIVISION FILES <br /> ler/NDERGROUND TANK'(U$T)CLEANUP SITE(LOP) 13 HOUSING ABATEMENT O SOLID WASTE FACILITY <br /> OTHER GL.ANUP 51'R(NON-LOP) ❑ FOOD FACILITY ❑ SOl..1D WASTE VEHICLE <br /> CJ <br /> 2WUNDFRGROUND TANK(MONITORINGfREIVIOVAL) CI DOG KENNEL DAIRY <br /> B CHICKEN RANCH 0 plid TREATMENT PLANT <br /> ❑ HAZARDOUS WASTE GENERATOR ❑ MOTELIHOTEL ' 0 pUMpER TRUCKIYARn1CHEM T4 TS <br /> 0 TIERED PERMITTED FACILITY ❑ POOLI5FA In I-AND USE APPLICATION SrrES <br /> C3 TATTOOIBODY PEIRCING d PUtjuC WATER SYSTEM 0 OTHER(PLEASE SPECIFY ABOVI) <br /> G M6l?ICAL.wABTR PAGIUTY <br /> 1. List up to ten addresses in the space above. Select the type(S)of files from the list above by Cho cking <br /> the appropriate box(es). At least one file type MUST be selected. F:ax to 209 484-01131] or ail t the <br /> address Indicated abpop 8. a zisL Anappointment for review wits be Confirmed <br /> 2. EHD will notifythea applicant if any EHD files <br /> approximately five business days bUt no later than ten(10)days after receipt of application. Thi files <br /> will be held for a maximum of five busIrIff s days for review. Appointments should be schedule, <br /> accordingly. <br /> 3. A file thrtt 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 w's $8g•00 dept! be reorganized by EHD staff prior to review- <br /> of the applicant. Future file reviews by the same applicant may require a <br /> 5, *T1=NTATIVE appointment dates must be confirmed With EHD staff. <br /> S. Applications received after 3:00,pm will be processed the next business day <br /> CONFIRMED APPOINTMENT DATE TIME <br /> FAX INITIALS <br /> DATE CONFIRMED <br /> REVIEWE13 ., YES NO REVIEW DATE <br />