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85/09/2003 14:48 9255517464 ENVIROF©RENSICS PAGE 01/01 <br /> PAMMMM <br /> MM <br /> FHO we <br /> moula— <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT L;Wt <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> L,003 STOCKTON CA 95202 <br /> (209)468-3420 <br /> : U IPUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT BUSINESSIAGENCY <br /> ADDRESS_Jl&29* .ab\t•t l.�oa S.fW A-'=Cj d.+iZ��LI�LJIS_. dl SG <br /> PHONE S s5I : Z FACSIMILE (j,S) <br /> TENTATIVE'AIPPOINTmEw DATE -fuss A J5�41% '11ME _[ .�Qt .+� _�-13� 3 <br /> (Please vivo 7 to 10 busbms thys from Mate of application submittal) <br /> CHECK IyOX TO EXPEDITE REQUEST.Il89QUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DAT}_ <br /> FILE ADDRESS THIS SIDIrlirD$11 AFF UlE MER <br /> PROGIUM 1"LENIVNTS SEARCH <br /> n _ <br /> JET X in <br /> .�lIH <br /> ENVIRONMENTAL HEALTH DIVISION FILETS <br /> NDERGROUN0 TANK(UST)CLEANUP SITE(LOP) a HOUSING ABEMI <br /> ATEW C3SOLID WAS1E FACILITYtl� fiER CLEANUP SITE".LOP) O FOOD FACILITY 0.SOUD'AIAS7E VEMCLE <br /> PUNDO ROUND TAW AMOWTORINGIREMOVAL) O DOG KENNEL M DAI;*Y <br /> Q HAZARDOUS WASTE GENERATOR O CHICKEN RANCH CI PKC;TREATL•IENT PUNT <br /> b TEM PE°RMIiTEO FACILITY M MpTELiHOTEL O PUMPER TRUCiVYARDMEiYI TONLETS <br /> D TATTOOfBODY PEIRCING Cf POOLfSPA Cl.W D USE APPLICATION SITES. <br /> O kimcAL wAsTE FACILITY 0 OTHER(PLEASE SPECIFY) __ _ <br /> 1. List up to ten addresses in the space above. Select the types)of Was from the list above by checking <br /> the appropriate box(es). At least one the type MUST be selected: Pax t _V09)491328 or mail to the <br /> -address Indicated above. <br /> 2. END will notify the applicant if any END 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 file_s <br /> will be held for a maximum of five business days for review. Appointme its sho uld be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by END staff may not be Intmediat�rly available for review. A now <br /> application may be submitted when the file Is available. <br /> 4. Any file not returned in the same condition as released will be reorganlzlld by EaD staff at the axpense <br /> Of the applicant. Future file reviews by the same applicant may require a$119.00 deposit prior V)review. <br /> 5. *TENTATIVE appointment dates must be confirmed with EMD staff. <br /> 6. Applications received aRsr 3:00 pm will be processed the next business day. <br /> Afft <br /> CONFIRMED APPOINTMENT DATE: TIME <br /> DATE CONFIRMED PHONE FAX 114MAL.S <br /> REVIEWED YES NO REVIEW DATE <br /> ��. <br />