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Ue/17/2009 09:96 FAX 209- 9460621 <br /> Q002/004 <br /> CAU tX¢even <br /> SAN JOAQUIN COUNTYPUBLiC HEALTH SERVICES 6-0 LOGtlYMIR <br /> E __ h �� ���� ENViRQNMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THiRD FLOOR <br /> SEP 1 7 2003 STOCKTON CA 95202 <br /> )468,U20 lqq7 <br /> '" U i3iJNMENT HEALTH <br /> PU13LIC RECORDS9RELEASE APPLICATION <br /> p <br /> APPLICANT_y�I p CS-Wa_C BUSINESS/AGENCY tl. t 1 FEIA�� <br /> ADDRESS <br /> PHONE_ 2O9 /qu8/ 17N — _ FACSIMILE__ 9 f` gSj06 2-1 <br /> TENTATIVE*APPOINTMENT DATE TIME to 1 Z� <br /> (Please alve 7to 10to 10 busln�ess days from date of application subm l) <br /> CHECK BOX TO EXPEDfrE REQUEST.; TAO F —REQUEST PROCESSED IN 3 BUSINESS DAYS t <br /> SIGNATURE OF APPLICANT DATE I V� C 4(:J�. <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY i 1"' t`"�) <br /> PROGRAM ELEMENTS SEARCH <br /> I i A <br /> L, r, AJ , (r <br /> M u S`� t-r ►� <br /> Oa p"' cr °Y't_ <br /> COLAft I -1 Ir <br /> I 1 ( V I. <br /> ts <br /> t,'�C�`f:r:�Jt`�r`•��)t f('.,�t/I(_-'- !'C/r-r', '�y` l <br /> ENVIRONMENTAL.HEALTH DIVISION FILES <br /> M UNDERGROUND TANK(UST)CLEANUP SITE(LOP) CI HOUSING ABATEMENT di SOLID WASTE FACILITY <br /> Q OTHER CLEANUP SITE".LOP) a FOOD FACILITY to SOLID WASTE VEHICLE ' <br /> UNDERGROUND TANK(MONTrORING/REmovAL) ❑ DOG KENNEL Oa DAIRY <br /> HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH IN PKG TREATM9NY PLANT <br /> TIERED PERtAfrrED FACILITY 0 MOTELIHOTEL O PUMPER TRUCWYAi=HEH TOILETS <br /> O TATTOOIBODY PEIRCING O•POOLfSPA "' ' IS*LAND USE APPLICATION SiTES <br /> Q MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM 0 OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses In the space above. Select the type($)of files from the rut 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. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense <br /> of the appiicanL 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 /> CONFIRMED APPOINTMENT DATE TiME,• <br /> DATE CONFIRMED PHONE FAX imrnALS <br /> REVIEWED YES NO REVIEW DATE <br />