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11/26/2002 TUE 15,45 FAX 916 X4356 j001/001 <br /> fl'� 6 2 2. 7 ) 4640199 ENVIRONMENTAL HEALTH PAGE 02 <br /> -4 <br /> SAN JOAQUIN COUNTYPUBUG HEALTH SERVICES <br /> NOV 2 ZflQ� ENVIRONMENTAL HEALTH DNiSION l <br /> v 304 PAST WEBER AVENUE,THIP D FL00it I 1077 x3 <br /> ht-AUI STQCKTON CA 9S20Z <br /> (209)468-3420 <br /> F'ERN�lTIS�hVI(� S PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT Jo •t <br /> he,,eo Ir DuslN sSIAC�Ncr GLw . 071 <br /> ADDRESS rJ/CFL.. <br /> P"O"E- l - — '-; FA4L Mn-E <br /> TENTATIVE"APPOruTmEHT DAT$ nmE <br /> (Please ylve 7 to 16 bus nass dslrs from clala a appllcatlon sUbmilcal) <br /> trt, • a <br /> CHECK 130X TO MEOrM RCQUEST-;09.00 FE -pEQUE T ED IN 3 BUSINESS DAYS ` v. <br /> SIGNATURE OF APPLICANT DATE // 0 2 <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS 51 AACH' <br /> D <br /> 'I <br /> ENVIRONMENTAL.HEALTH DNISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT O SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) 13 FOOD FACTUTY O SOLID WAS'M VEHICLE <br /> UNDERGROUND TANK(MONITORWGIREMOVA14 O DOG KENNET- O DAIRY � <br /> sAZARDOus WASTI:GENERATOR 13 CHICKEN RANCH 10 PKG TRfAT1uF�r VeJwT <br /> t� VWFZED PCRMnT'FD FAC1Lnr A 0 OTEL1HOTEL 0 PUMPER TRUCWYARW 14EM YOILETS . <br /> Q TATTUQ100pT PEIR(:TNO T] PgOt15PA 0 LAND USE APPLICATION SrrfZ <br /> .iQ MEDICAL WANE FACILITY y 0 PUBLIC WATER SYSTEM d OT1 iElt(PLEASE SPECIFY ABOVE) <br /> 1. List up to tan addresses In the space above. Select the types)Of files from the list above by checking <br /> the appropriate box(es). At least one rile type MUST be selected. Fax to(2091464-0138 ormail to the <br /> address_indiCated ab•ova�. 0 <br /> 2. EHD will notify the applicant if any'EHO files exist. An appointment for review will be confirmed <br /> approximately fivo business days but no later than ten(10)days after receipt of application. The files <br /> will•be hold for a maximum or fve business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A Ilio thatls•actively b0ing worked on by i:HD staff may not be Immediately availwble for review. A new <br /> application ma be submitted when the flte is avallable. <br /> y staff at the eX ense <br /> 1!4 An file not retlirnad lit the same condition as released will be reorgznizad 1)y EHD s p <br /> Y <br /> of the applicant. Future file reviews by the same applicant may require a$09.00 deposit prior to review, <br /> S. 'TENTATIVE appointment dates most be confirmed with EHD staff. <br /> G. Ap licatlons ecCived after 3:OQ pm will be processed the next business day. <br /> I1:- I - <br /> FIRMED <br /> ED APPOINTMENT D&E. 11ME ' <br /> FPHONE FAX .INITIALS <br /> YES NO REVIEW DATE _ <br />