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07/17/03 10:18 FAX 214 630 7070 HBC ENGINEERING 10001 <br /> ............. <br /> DATE RE <br /> f, F"o 1.00 NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENV, ' <br /> -JUL 1 7 2003 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> 111 f Ic.NLI H (209)468-3420 <br /> 1. _-,k.\/1GP_UI3LIC RECORDS RELEASE APPLICATION <br /> APPLICANT PPIO�- BUSINESSIAGENCY <br /> - _ibL - <br /> ADDRESS <br /> PHONE C� (Ola FACSIMILE c-�21"kOiC>- rW7 <br /> TENTATIVE*APPOINTMENT DATE mouc�(_ r7 al 03 TIME <br /> (Please give 7 to 10 business days froib e of application submittal) <br /> CHECK BOX TO EXPEDITE REQU T-$89.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS tin <br /> SIGNATURE OF APPLICANT DATE <br /> THIS SIDE EHD STAFF USE ONLY <br /> FILE ADDRESS PROGRAM ELEMENTS SEARCH <br /> IOL41 (Z-5+br-A(-1 <br /> a Htl <br /> EMIJ <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) M HOUSING ABATEMENT 0 SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) M FOOD FACILITY E3 SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) 13 DOG KENNEL 0 DAIRY <br /> HAZARDOUS WASTE GENERATOR E3 CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> 0 TIERED PERMITTED FACILITY 13 MOTELIHOTEL C3 PUMPER TRUCKfYARDICHEM TOILETS <br /> 13 TATTOOIBODY PEIRCING 13 POOL/SPA 0 LAND USE APPLICATION SITES <br /> 13 MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> 1. List up to ton 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. EHD staff at the expense <br /> 4. Any file not returned in the same condition as released will be reorganized by <br /> of the applicant. Future file reviews by the same applicant may require a$89.00 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 /> NE FAX' INITIALS DATE CONFIRMED -PHO ALS <br /> REVIEWED YES NO REVIEW DATE <br /> EH04&0Z&" <br />