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12/07/2001 11:42 '303-39346 OFFICEMAX N 0627 PAGE 01 <br /> GATE HECENEO <br /> SAN AQUIN COUNTYPIJBLIC HEALTHIORVICES END LOG NUMBER <br /> ENVIRONMENTAL HEALTH DIVISION <br /> l� /1 304 EAST WEBER AVENUE,THIRD FLOOR # �/ <br /> (� STOCKTON CA 95202 <br /> (209)468.3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT BUSINESSIAGENCY McN1eQL-k .� <br /> ADDRESS 351\ tJex�tk+ \Vrct?510� rs�JE. . \ALto r�G�f�� �J�3-17 <br /> PHONE FACSIMILE� 4-1) �•-T'a.�-�_�•-+b <br /> TENTATIVE'APPOINTMENT DATE 1��'I' c�2 TIME cx-' <br /> (Please(live 7 to 10 business days from date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$79.00 FEE—REQUEtS�� ROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT r lam- DATE <br /> FILE ADDRESS -- <br /> __ \\L!-rj WE�C CF40.fZtE�- wA 3'ccc�c-•vc..� (ry <br /> oPA PET2a".7i_�,fY\ GomPaN`J n < o G__.. <br /> �3 aV4 OWOf �. g'coc+LSorJ <br /> L lY _C� T�ol� V-0 <br /> CYTO <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> 37 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> G(�THER CLEANUP SITE(NON-LOP) C1 FOOD FACILITY 13 SOLID WASTE VEHICLE <br /> 67 UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> ❑ HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTEUROTEL ❑ PUMPER TRUCKIYARDICHEM TOIETS <br /> ❑ TATTOO/BODY PEIRCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) ' <br /> t. 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 $78.00 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 /> EH W 14 01M900 <br />