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09/03/02 TUE 07:07 FAX 415_892 9475 PES ENVIRONMENTAL �QO1 <br /> -08/30/2002 15:34 205.;3433 FIFTH FLOOR PAGE 02 <br /> SAN JOAQUIN COUNTYPUBLIb HEALT ERVI 7 <br /> H <br /> w ENVIRONMENTAL HEALTH D1VISIQN <br /> 304 EAST WEBER AVENUE,THIRD F"1.00R tn ECE�WEF�l <br /> lJ <br /> STOCKTON CA 95202 <br /> {209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICA'1"lON SEP 0 3 ZOOZ <br /> APPLICANT Sq�� .AzR,-%AvghsFNVI��}��p�ENT HEALTH <br /> - 8US1HIwSSIAOENCY T'C S -,mat,�.A.r ra k�rr7",4t• 4Wt"�4Y' <br /> ADDRESS h4ovh'T0 3L.V M• s7► Ia0 ►4oJh7o C/�F 9`{CI 4'7 <br /> PHONE <br /> q/ l� oZ <br /> TENTATWEMAPPowmENTDATE TIME q.l -t-.N <br /> (Please pEYe Llo �, ��roht f apio <br /> submittal) <br /> ll <br /> CHECK BOX TO IzxPERf7 R13QUE3T•X89.00 EI:_REQUEST pROCIN D 1IHSS$DAYS y 1 <br /> SIGNATURE OF APPLICANT <br /> DATE <br /> 3 <br /> T=ILE ADDRESS THIS SIDE END STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARC14 <br /> A I lL o R w w S-ro WcTo N , <br /> 1.1 rt.P O R.-V —a f Tn c ic~ru4 / <br /> 10F'1b 0 STize AT S'TO C/47 o 04 Lj <br /> Z.7 O C] T. C A&-I F o R r4 1 T-r" — S Ta t{c-r ft r4 „ p� ��n.,r. c+�• <br /> Z�{oZ 5 . «+4-i FaRrl+h s 772d�?T T7atkrro►! v,.,r�, <br /> - <br /> 31oS' r. eL 010. bo S'rP..dB STocle r.�rf <br /> B3� t�. S'rtil S-rRt'�T S i otic.Tdr-f <br /> t <br /> ENVIRONMENTAL HEALTH OMSION FILES <br /> �LINOERGROUND TANK(UST)CLEANUP SITE(LOP) 0 14OUSING ABATEMENT 0 SOLID wASTE FAcILRY <br /> L°f OTHER CI EANUP SITE(NON-LOP) O FOOD 1=ACiLRY 0 SOLID WASTE wmcLk <br /> G?r UNDERGROUND TANK(MONrMRINGIREMOVAL) d DOG KENNY 13 DAIRY <br /> WHAZARUOUS WASTE GENERATOR Cl CHICKEN RANCH d PKG TRIrATMENT PLANT , <br /> a TERED PERMIMI)FACILITY O MOTELMOYEL 0 PUMPER TRUCfWARDICHEMI TOIL= <br /> 0'TATTMHODY P619CING 0 POOUSPA 13 LAND use APPL=A'CION SITES <br /> 0 MEDICAL WASTE FACILITY 0 PUBLIC WATER SYSTEM C3 OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses In the space above. Select the type(s)of files from the list above by chehldng. <br /> the appropriate box(es). At least one fife type MUST be selected. Fax to 12091464-01;0 or mall to t 1: <br /> address Indigated al ve. <br /> 2. EHD will notify the applICO nt if any EHD flies exist.-An appointment for revlew will be.confirmed . <br /> approximately five bu iness days but no Fater than tan(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 b6ing worked an by EHD staff may not be lmmedlntely available for review. A new <br /> application may be submitted when tho file Is available, <br /> 4. Any file.not returned 41 the same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Future film reviews by the same applicant may require a$89.00 deposit prior to review. ' <br /> 5. 'TENTATIVE appointment date9 must be confirmed with EHD staff. <br /> .6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT BATE, TIME ` <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> 4 <br />