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FROM :CTE-Esc. FAX N0. :7605460328 0Jun. 17 2002 11:3GAM P1 <br /> "w�Mir,jV`I,gYtiJ : r 4 ENVIRONMENTAL_ WALTH PAGE 01 <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> v 304 EAST WEBER AV>=MUE,THIRD FLOpFt I <br /> > 7 1= 3 F sro209)as 3420 <br /> PUBLIC RECORDS RELEASE APPLICATION � <br /> APPLICANT <br /> eustt+rESSrAGENCY 0-b �I1'vcAB/ti <br /> ADDRESS Zq4 V'n� d S"T�. G CA- 'ilz0z <br /> PHONti 740 `f45S FACSIMILE -76D- Wto- 2!?Oro <br /> I <br /> TENTATIV)w APpQINTMENT OATIs 4 2S /pZ TIME • ' <br /> _.! I• aIa <br /> (Please,giu*7 to 10 btalne s d m dste o application sut+mlttal) <br /> CHECK DOX TO EXPEDITS REQUEST•$89.00 FEE-REQUEST P �S9E N�BUSINESS PAYS <br /> Z� ' <br /> SIGNATURE OF APPLICANT �ll��+c DATE 6/17/r'Z. <br /> FILE ADDRESS THIS SIDE IiEHD STAFF U39 ONLY , <br /> .PROGRAM ELEMENTS SEARCH <br /> 3 os EIAWc}} <br /> 31 rI rOu'ffi E <br /> 0 C—i o S�Fn <br /> Z057- SOJ"O UanaAo <br /> ENVIRONMENTAL.HEALTH DIVISION FILES <br /> UNLIERGROUN13 TANK(UST)CI..EANUP SITE ILOP) A HOUSING ADATOMENT 0 SOLID WASTE FACILITY <br /> OTHPIR CLMNUP SITE(NON-LOP) C FOOD FACILITY ❑ SOLID WASTE VEMCLI� <br /> UNDMOROUND YANK(MONITORING/REMOVAL) M 000 KENNEL • d DAIRY <br /> ❑ FIAZARbOUS WASTE GENERATOR d CHICKLH RANCH 0 PKG TRIIATMENT PLANT <br /> G TIERED PERM"D FACILT1Y 0 MOTELMOTEL M PUMPER TRUCVJYARD1CHtkM TotLg" <br /> D TATTOnlRODY PEIRCING Q POOWSPA tU 14AND USE APPt.ICA7ibN s"s <br /> ❑ MEDICAL WASTE FACHAV c a PUBLIC WATER SYSTIM b OTHER(PLEASE sPECIFY A$OVg) <br /> 1. L)st up to ten addrasses In the space above. Select the type(s) from the files frothe list above by checking <br /> the approprinte box(es). At laastOng file type MUST he selected, Eax toJ2091 464-0138 0 <br /> r WgIll t9 thg <br /> dr ss(nd c ted lboyll, , <br /> 2. EHD will notify the applidAnt 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 flies <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 END staff may not b4 Immedlataly available torroview. A new <br /> application may be submitted when the file is available. <br /> 4. Any fIf*not returned In the same condition as releasbd will be reorganized by EHD staff tit the exponso <br /> of the applicant. Future file reviews by the same applicant may require a$89.00 deposit prior to review. <br /> 6- 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> .B, Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE._ _ _ _ TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> R$Yll*WEl] YES NQ REVIEW DA1'l; <br />