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U U14((ff <br /> '1�-14-2000 03:16M FROM TO 19163729065��� <br /> .4:Ylveu P 01 <br /> SAN JOAQUIN.COUNTYPUBLIC HEALTH SERVICES C01uu aumue <br /> JUL 2 ZUOI ENVIRONMENTAL HEALTH DIVISION <br /> EN 304 EAST WEBER AVENUE,TI-11111) 5 FLOOR J 7-3 I <br /> PERM 1T S I V I "t- TH STOCICrON CA 95202 <br /> / ERViCES (209)"&3420 <br /> �1PUBL�IC RECORDS RELEASE APPLICATION( <br /> APPLICANT -e <br /> Y1'may, e� `� -L-7 ' SUSINESSIAGENCY � ) �- K V !t 1J a <br /> ADDRESS DJ V C 6 -` <br /> PHONE /v 1;L13— LI/ FACSIMILE <br /> TENTATIVE'APPDIP TMENT DATE_ ! t7.7 TIME <br /> '213 <br /> (Please give 7 to 1e bUSIM"da S trcm date of a kation sutuRrnan <br /> CHECK BOX TQ EXPEDITE REQUEST-fa rfFEE- ST PdO�SPD IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> FILE ADDRESS THIS SIDE EHD STAFF UONLY I� <br /> D O _ P"PAM ELEMENT6,8EARCH f <br /> 3Sa La `{ <br /> 00 Lo <br /> OD o 0 <br /> a o C (' <br /> d � _ <br /> . I <br /> I <br /> -50 <br /> II`r <br /> ENVIRONMENTAL HEALTH DIVISION FILES f <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT Pk SOLID WASTE FACWTY <br /> OTHER CLEANUP,SITE(NON-LOP) ❑ FOOD FACILITY ❑ SO11D WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORMGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WAST&OENERATOR ❑ CHICKEN RANCH ❑ PKU TREATMENT PLANT <br /> X TIERED PERMITTED PACIUTY - 0 MOTEUNOTEL ❑ PUMPER TRUCK/YARDICHBM TOILETS 4 <br /> ❑ TATTOCIBODYPEIRCING - ❑ POOUSPA ' ` " ❑ LAND USE APPLIBATION SITES <br /> ❑ MEDICAL WASTE FACILITY J21.PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above, Select the types) of files from the list above by checking <br /> tha appropriate bog(es). At tease one file type MUST be selected. Fax to (2(19)464-0138 or mail to the ` <br /> addEess Indicated Rbove, f <br /> 2. EHD will notify the applicant It any EHD flies exist. An appointment for review will be confirmed <br /> approximately five business days but no tater than ten(10)days after recelpt of application. The tiles I <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 EHD staff may not be Immediately available for review. A new I <br /> appllcatkon may be submitted when the file is available. <br /> A. Any ttlT not returned In'the same condition as released will be reorganized by EHD stafrat the expense <br /> of the,applicant. Future file reviews by the same applicant may require a$87.00 deposit prior to review. <br /> S. *TENTATIVE appointment dates must he confirmed with EHD staff. <br /> 6- Applications recelyed after 3:00 pm will be processed the next business day, <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE PAX iNITMS <br /> REVIEWED YES NQ REVIEW DATE <br /> MOO f4 O 7= <br /> .TOTFL P.01 <br /> I <br /> vnnft 'rnn4-03UTTRa canR sir ora vva rC:nr in/v7/,n <br />