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r <br /> T f <br /> __, 8/21/2002 11:44 FAX 209 948 L.)1 KLEINFELDER 16002/002 <br /> G.RREGOvCb Via NUMBER <br /> SAN JOAQ IR NTC HEALTH SERVICES <br /> ENVIRONMENTAL <br /> HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 p (� <br /> (209)468-3420 �rc U/S-•((1 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> " <br /> APPLICA ���"�yC L BUSINESSIAGENCY <br /> NT <br /> g�5 i7y� �' , C, N�IRONMENI nti;Lhi <br /> ADDrcEss <br /> .PHONE %p ye �? y� FACSIMILE <br /> 9`I�� '- qq <br /> TENTATIVE*APPOINTMENT DATE ^ nME <br /> (Please give 7�business WOMB�{@ ofAN "IUSINESS <br /> tion submittal) i .. <br /> N �7 3 <br /> CHECK BOXTO EXPEDITE REQUEST-$87.00 FEE-REQUESTPROCE---- IDAYS <br /> SIGNATURE OF APPLICANT DATE ��^��� <br /> I <br /> FILE ADDRESS THIS SIDE EHD STAFF uuE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> p�0 <br /> 6-11C4, De;ve 34f4+ ee,* <br /> 1 <br /> i <br /> ff` <br /> e I <br /> i k <br /> 1 I <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> 129W=7 <br /> NO TANK(U577 CLEANUPSRE(LOP) 0 HOUSING ABATEMENT 0 SOLIDWASTEF�ILITYNUP SITE(NONLOP) O FOODFACILITY 0 SOLn)WASTEM911CLE <br /> UND TANK(MONTTORDiGlREMOYAL) • CHI KEN RA 0 DAIRY I <br /> S WASTE GENERATOR (7 C pT"RANCH O PKG TREATMCK PLANT <br /> hIRTEDFACILRY O MOTELlNOTEL 0 PUMP ERTRUGIO�fA'nON SITES <br /> } <br /> O TATTOOrBODYPEIRCING CITOOUSPA D LANDUSEApPLICATIONSTTES <br /> 0 MEDICAL WASTE FACILITY 0 PUBLIC WATER SYSTEM Cl OTHER(PLEASE hFECIFY ABOVE) <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the Ilsttabove by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(20914§0133 or mail t0 11e C <br /> address in <br /> above. . I <br /> 2. EHD will nofdy the applicant if any EHD files exist. An appointment for review will he confirmed <br /> approximately five business days but no later than ten(10)days after receipt of apincation- The files <br /> will be held for a maximum of five business days for review. Appointments shouldjbe scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immediately availa�e for review. A new <br /> application may be submitted when the file is available. I <br /> 4. Any file not returned in the same condition as released will be reorganized by EHDlstaff at the expense <br /> of the applicant Future file reviews by the same applicant may require a$87.00 deo osit prior to rev)ew. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. j{ <br /> 6. Applications received after 3:00 pm will be processed the next business day. I <br /> CONFIRMEDIAPPOINTMENT DATE TIME f <br /> PATE CONFIRMED PHONE FAX INITIALS <br /> I ' <br /> REVIEW DATE <br /> REVIEWED ;j YES NO <br /> i <br /> • i <br />