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OCT-17-2002 14:53 SHAW E RND i SAN JOSE 408 437 9526 P.02/02 <br /> DAIt kk CL NED 2"I'00-umem <br /> SANS-JAQUIN CQUNTYPUBLIC HEALTH RVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> v <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> CA O bI STOCKTON(209) d6B-3420 2 OCT 1 7 2002 <br /> 3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT J_ owvR/ ac1UG-I BUSINESSIAGENCY ShQ.�✓ GN�'ronmr'� I f�F i�� <br /> ADDRESS ! 92i/ gt) L. Df7 Ave <br /> PHONE y0 Ste- �SO"Sb 77 IMILE <br /> TENTATIVE'APPOINTMENT DATE 10/-2 y/2 TIME cT- n2 haD_ <br /> (Please give 7101 b ss da from or appllcallon submittal) <br /> (plea"give <br /> IJ CHECK BOX TO EXPEDITE REQUEST•109.00 FEE-REQ $1 E ED IN]BUSINESS DAYS <br /> SIGNATURE OF APPLICANT Q� DATE <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> Sb u. GG B S n <br /> S - <br /> O u S <br /> 210_3 ati s <br /> S G <br /> f 03 B <br /> tl G.4 <br /> )k74s <br /> ENVIRONMENTAL.HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT 0 SouO WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) O FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL D DAIRY <br /> HAZARDOUS WASTE GENERATOR CI CHICKEN RANCH 0 PKC TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY 0 MOTELIHOTEL 0 PUMPER TRUCKIYARD/CHEhl TOILETS <br /> d TAYTOOIBODY PEIRCING - ❑ POOLJSPA 0 LAND USE APPLICATION SITE'S <br /> ❑ MEDICAL WASTE FACILITY 0 PUBLIC WATER SYSTEM O OTHER(PLEASE sPEGFY ABOVE) <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 (209) 464.0138 or mall 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 fora meximum 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 applicant. Future file reviews by the same applicant may require a $89.00 deposit prior to review. <br /> S. '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 /> TOTAL P.02 <br />