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Jul . 8 . 2002 11 : 59AM CONDI" GARTH TECHNOLOGIES L IES No• 0268 P. 1/1 <br /> GATE REC <br /> SAN JOAQUIN CDUNTYPURI.IC HEALTH SERVICES &W LOG MIMSEA <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 D 9 <br /> (209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT_M MEQ M 411/ _BU31NESSIAGENCY cop-)bop- <br /> ADDRESS <br /> oNbop- <br /> ADDRESS 18b F2� Sr c (�c t � T'E- c t�-T cA `T S-.v 6 <br /> PHONE QP9-174-) FACSIMILE 3L{-0573 0 <br /> TENTATIVE*APPOINTMENT DATE TIME <br /> (Please glue 7 to 10 business da from date43P <br /> iicatlon submittal) r •'_ ' <br /> CHECK BOX TO EXPEDITE REQUEST-$87. FEE—REQUEST PRO 55E <br /> BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ` DATE - 7-/8/,:7 <br /> FILE AOORE55 THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> 15• "o K7w <br /> 5 <br /> 0 <br /> ¢S- S w/r`f <br /> Kt- va&y 1 <br /> atio 5, Pa t- w y <br /> 29q 5, Apo e- w <br /> $3� �• �r <br /> V y �1�Iz <br /> � <br /> 12- s. /an rcfpl-r 4a 1 UU <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUPSITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY O SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> �) HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARD/CHEM TOILETS <br /> ❑ TATTOO/BODY PEIRCING C] POOL/SPA ' , Q LAND USE APPLICATION SITE$ <br /> 51 MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. 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, Faux 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 $87.00 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 /> GONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br />