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07/23/2004 10:22' FAX 209 948062 /4402/002 <br /> (7 010 LOG UIRMERSAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> AL 2 3 2004 ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVIrNUE,THIRD FLOOR * `Q <br /> ENVIRONMENT HEALTH STOCKrON CA 95202 <br /> PERMIT/SERVICES (209) 468-3420 � <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT. / 2crGl/ _BUSINESSIAGENCY `erW'Ze [ .ffCj— <br /> ADDRESS <br /> PHONE 7 ,9yg �r YS� FACSIMILE � q ,. Oki'Oft A IA,A�I,I <br /> - *,0 <br /> TENTATIVE*APPOmeNT DATE � �0 7 TIIIRE <br /> INT '`�� �✓l-1 <br /> (Please give T to IQ business days froth date of appfleadon Buba ftag ' <br /> C3 CHECK BOX TO EXPEOfTE REQUEST-WXO FEE–REQUEST PROCESSED IN 3 BUSINESS DAYS 8OL',SIGNATURE OF APPLICANT iG1 . [`� DATE � <br /> FILE ADDRESS THIS SIDE EHD'STAFF USi_ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> /0, 79 6 44ft Vt <br /> /D 2 96 zhifer'; o <br /> k <br /> . ENVIRONMENTAL HEALTH DIVISION FILES �Q <br /> UNDERGROUND TANK(UST)CLEANUP SITE(L.OPI ❑ HOUSING ABATEMENT SOLM WASTE FACJLITY <br /> £R <br /> GTHCLEANUP SUE(NON-LOP) 0 FOOD FACILITY ❑ SOLID WASTE VEE! � A <br /> UNDERGROUND TANK(MONITORINGIREMOVAU DOG KENNEL DAIRY <br /> ( HAZARDOUS WASTE GENERATOR CHICKEN RANCH <br /> C] •s PUIMER <br /> TIEiFD PERNn ED PACRY d MOTEl1HOTEL PMPERTYARWCIEbA TOILETS. <br /> E3 TATTOOODYPEiRGING 0•PO.OMPA <br /> V �O <br /> - . LAND USE APPLICATION 5rfES <br /> ❑ MEDICAL WASTE FACIUW XPUBLIC WATER SYMM O (]THER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above. Select the type(s)of files ftom the list above by checking <br /> the appropriatd box(es). At least one file type MUST he selected. Fax-to 209 464-8138 or mail to the <br /> Address indicated above. <br /> 2. F.HD 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 I5 available. <br /> 4. Any file not returned in the same condition as released will be reorgantxed*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 revie.W. <br /> 5. "TENTATIVE appointment dates most be confirmed with EHII staff. <br /> 6. Applications received after 3:00 JIM will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME. _ <br /> DATE CONFIRMED PHONE FAX INM ALS _. <br /> REVIEWED YES NO REVIEW DATE _ -- - <br /> i <br />