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From:SanJoCo-Oakland Office 510-336-9119 -- Tami Date:4/16/2002 Time:4:1--2 PM ` bN Page 2 of 2 <br /> 4 Iv <br /> 0 /16/2002 16:40 4640138 ENVIRONMENTAL HEALTH PAGE 01 <br /> vArc xteevreu <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> q4 W1 ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WESER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> (209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT__DA \ fA--1 Y.,N S. BUSINGSWAGENCY sof_ _�, J_) Qi), <br /> ADDRESS i-17-C), (-� p[.t, A — <br /> *cc..4.,.� tel' 2 —1451 <br /> r3 <br /> PHONE %0 FACSIMILE-,-6_y j)- 22, <br /> TENTATIVE*APPOINTMENT DATEZS 4 A P2, ZEaZ TIME <br /> Pleas Iv 7 a 10 buslnoc d ��-�� ' <br /> ( 9 ram f appliCet' submitter) <br /> C1 CHECK BOX TO EXPEDITE REQUE�7S9. j UE OCE V But$DAYS <br /> . <br /> SIGNATURE OF APPLICANT DATE C' <br /> t <br /> FILE ADDRESS THIS 910E EHD STAFF USE ONLY <br /> PROGOM ELEMENTS SEARCH <br /> --�e S <br /> 2 a . <br /> ;2 15521 3Szg IL <br /> LA <br /> ab ►tit rJ W ►( a L <br /> -4 d e p <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE PACILITY <br /> OTHER CLEANUP SITE(NON-LOP) c3FOOD FAcurY ❑ SOLID WASTE VEHICLE <br /> NDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIEREO PERMITTED FACILITY ❑ MOTEUHOTEL' ❑ PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑ TATTOOIBODY PEIRCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILI Y PUBLIC WATER SYSTEM ❑ OTHER(PLEAS?SPECIFY ABOVE) <br /> 7. 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)484-0138 or mail to the V <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 9ptivety being worked on by EHD staff may not be immediately available for review. A new <br /> application may be stlbm)tted when the rile is available. <br /> .4. Any file not returned in the same condition as released will be reorganized by END 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 /> 6. *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 INITIAILS <br /> REVIEWED. YES NO REVIEW DATE <br /> 9a� <br /> ' h <br />