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1 rL - <br /> DATLIII1CIVFD f et7r <br /> SAI �AQUIN COUNTYPUBLIC HEALTh :RV 11 <br /> ~ ENVIRONMENTAL HEALTH DIVISION <br /> 3041=0$1 YVEDBR AVENUE,THIRD FLOOR AUG 0 2 2002 <br /> STOCKTON CA 95202 <br /> (200) 468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATIIF <br /> � VIR E T <br /> ICANT ���G I'� J� J �V�, BUSIN68SIA02NCY <br /> PHONE <br /> TENTATIVE'APP0INTMENTOAT6 Q h— TIME e— <br /> �}Q'��+ (Pluu elvrr Ile 106"Inaaa dpplleatl ■ubrfl111i1 <br /> )"( CHECK BOX TO EXPEDITE REQUEST-Sa9'6E •'� PR E El a NE68 DAYS . <br /> 31GNATURE OF APPLICANT DATE 'fZ-` '- <br /> 40 <br /> FILE ADDRESS THIS SIDE RHO HTAFP USR ONLY <br /> PROORAM BLBMBNTO SEARCH <br /> 00 E Lool e f <br /> 0 2 aI In U1 t • - <br /> ZO Lo C( Lo ' <br /> 0.G <br /> D <br /> ENVltfil3NMENTAL HEALTH DIVISION FILES <br /> 1�NDEROROUNO TANK NST)CLGANUP 9rTr,(LOP) O HOUSINO ABATEMENT /o SOLID WASTP FACILITY <br /> r4 �8 OTHER CLEANUP SITE(NON10P) C FOOD FACILITY ❑ 801,10 WASTE VHNICLE <br /> �NOCROROUND TANK(MONr MItIN&MPMOVAL) ❑ DOO KENNEL C DAIRY <br /> AZARDOUS WASTE OENERATOR Q CHICKEN RANCH ❑ PKO TREATMENT PLANT <br /> O TIERED PERMITTED FACILITY ❑ MOTELIHOTEL O PUMPER TRUCK/YAR=HEM TOI).ET6 <br /> �• ❑ TATTOCIBODY PBIRCINC ❑ POOLWA ❑ LAND USE APPLICATION SITES <br /> �10 O MEDICAL WASTE FACRITY ❑ PUBLIC WATIIR SYSTUM 0 OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses In the specs aboYO. ltoleet the typa(s) of 11109 from the list above by chocking <br /> the appropriate box(os). At least one file type MUST be selected. tray to (2091464-013a or r" to the <br /> a- address Indicated above. <br /> 2. EHD will notify the applicant If any EHD foes exist. An appotntment for review will be confirmed <br /> I�( approximately five business days but no later than len(10)days after receipt of application. The fills <br /> will be held for a maximum of five business dogs for revlew. Appointments should be scheduled <br /> accordingly. <br /> 3. A fin that Is actively boinp worked on by VO scarf may not be Immediately available for review. A new <br /> application may be submitted when the file l9 available. reorganized b EHD staff at the expense <br /> A. An file not returned In the same condition as released will be y <br /> of the applicant. Future file reviews by the some applicant may require, a E89.00 deposit prior to review. <br /> g, '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 DATO TuwE <br /> l <br /> DATE CONFIRMED _ _ PHONE FAX INITIALS <br /> i <br /> REVIEWEDVfiS N. .. REVIEW--DATE <br />