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FROM : NOA Environmental • PHONE NO. : 209 369 4228 . Sep. 20 2002 0�Hu1 44PNUMB"2 <br /> DATE RECEIVED <br /> SAN JOAQUIN COUNTYpUBLIC HEALTH SERVICES <br /> O VEAST W E ER A HEALTH DIVISION ! O <br /> 04 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> V �y <br /> (209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT PNOIJ(6y BUS/INESSIAGENCY/� NIDA �vWr'rovt✓h C��� ' �� �--� <br /> ADDRESSS (7 I,1. f-t"oJ57d✓t Lri. LoQ.--,; 64 q ZOO <br /> PHONE (Z-09) 36"7? 3 701 _ FACSIMILE�Ze4) 369 - ` Z-1. 8 <br /> ��++ •ENVIR ONMEPff HEALTH <br /> pppIII �4 Z- TIME 7 .�<'. "" 'hrRmITIR VICES <br /> TENTATIVE'APPOINTMENT 9A�o10 Ines 0 frpm of g0on su Qr � o -CHECK BOX TO EXPEDITE REQUEST-$89.00 FEE- QU TPROC�11XNE AYS <br /> fes_ <br /> SIGNATURE OF APPLICANT DATE <br /> FILE ADDRESS THIS SIDE END STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> C9 <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> CI HOUSING ABATEMENT C9 SOCIO WASTE FACILITY <br /> 6 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) in FOOD FACILITY 13SOLID WASTE VEHICLE <br /> ® OTHER CLEANUP SITE(NON-LOP) 17 DOG KENNEL ❑ DAIRY <br /> E UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> HAZARDOUS WASTE GENERATOR ❑ MOTEUHOTEL ❑ PUMPER TRUCK/YARDICHEM TOILETS <br /> ❑ TIERED PERMITTED FACILITY ❑ POOUSPA ❑ LAND USE APPLICATION SITES <br /> ❑ TATTOO/BODY PEIRCING ❑ PUBLIC WATER SYSTEM 6r OTHER(PLEASE SPECIFY ABOVE}. <br /> ❑ MEDICAL WASTE FACILITY . <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. Fax to to (209)464-0J38 or mail to the <br /> or mail to the <br /> address indicated above. <br /> 2. EHD will notify the applicant if any EHD files exist. to appointment for review will be confirmed <br /> ut no later than ten (10)days after receipt of application. The files <br /> approximately five business days b <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. Y being worked on by EHD staff may not be immediately available for review. Anew <br /> 3. A file that is actives Y <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 $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 /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br />