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�J iu <br /> uti ' SAN JO,�tU1N COUNTYPUBLIC HEALTH SbKVICES <br /> ENVIRONMENTAL HEALTH DIVISION FJ <br /> APR 1 9 2001 304 EAST WEBER AVENUE,THIRD FLOOR b <br /> STOCKTON CA 95202 <br /> ERJ`d!' k ,: i!LE % H (209) 468-3420 <br /> '-Si=RVICES PUBLIC RECORDS RELEASE APPLICATION <br /> - <br /> APPLICANT U A•J BUSINESSIAGENCY //y IC tl e h�_ C-'V/i/ 7 J <br /> ADDRESS 23ffD 1,9 -no i LC Ljo <br /> PHONE 3,�O /J 7�-,Z 3 .�— FACSIMILE r�.,�/� �G��-_'�J•�3�s� <br /> TENTATIVE"APPOINTMENT DATE w'TL �JO wC-�^ l JI TIME <br /> (Please OiVe 7 to 10 business days from ate of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$87.00 FEE-REQUEST PROCESSED IN 0 BUSINESS DAYS /\ <br /> SIGNATURE OF APPLICANT /4— DATE U O <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> ELM s7 Luo/: • 35:2'1 <br /> /V L T. L.Oi✓I <br /> / m <br /> S7 <br /> In G - G✓rLn S7. L6�i 9.5.2 _� <br /> /V Sroc/CTo c/ , Lo0 i <br /> G S iV. Srocl.>-o.✓ , <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> LYGNDERGROUND TANK(UST) CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> BOTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> 3--U-NDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> CL-KAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY - ❑ MOTELIHOTEL ❑ PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑ TATTOOISODY PEIRCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ 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 checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0138 or mail to the <br /> address indicated above. <br /> 2. EHD will notify the applicant 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 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 being worked on by EHD staff may not be immediately available for review. A new <br /> application may be submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a $87.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FINITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> Eil 00 14 OW07100 <br />