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07/23/2004 10:22 FAX 209 948062 x]002/002 <br /> D ( _ <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> )UL 2 3 2004 ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE.THIRD FLOOR #13 <br /> ENVIRONMENT HEALTH STOCKTON CA 95202 <br /> �/="PERMIT/SERVICES (209) 468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT_ /i?GV /c J ga t1y 1. _BUUSINESSIAGENCY <br /> ADDRESS 0� G�4$T C (i�T <br /> PHONE !�� 9 17 "/ Y FACSIMILE � / o � ¢�� f <br /> TENTATIVE*AppOINTmENT DATE Q TIME +00 ✓;, Li <br /> (Please give 7 to 10 busMess days hvm date of appprat3an suhn*tan <br /> ED CHECK BOX TO EXPEDITE REQUEST-$87.00 FEE—REQUEST PROCESSED IN 3 BUSINE5S DAYS ot(SIGNATURE OF APPLICANT .�c�[� DATE " ! � <br /> FILE ADDRESS THIS SIDE"D STAFF USE OtiL.Y <br /> PROGRAM ELEMENTS SEARCH <br /> 701 -7,16 vts <br /> d <br /> 3 <br /> '1 <br /> . ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANTS(UST)CLEANUP STET~(L)OP) 13 (SOUSING ABATEMENT �SSOLO WAS-M <br /> Qt10 41[ASTI+VEH FACILITYY� <br /> OTEANU <br /> HER CLP SITE(NON-LOP) 0 FOOD FACILITY <br /> UNDERGROUNI]TANK(MONITORINGIREMOVA-0 C ,DOG KENNET. DAIRY � <br /> K HAZARDOUS WASTE GENERATOR CHICKEN RANCI4 PKG TREATMENT <br /> MAlly 0 TIERED PERMITma FACILITY D MOTE LIHOTIYE. , C] PUMPER TRUGK/YARWCWM TOILETS <br /> M TATTOOl84DY PEIRCING In•PbOLISPA• '• LAND USE:APPLICAiTON 5ITE5 <br /> C3 MEDICAL WASTE FACILITY PUBLIC WATER SYSTEM 0 OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses In the space above. Select the type(S)of gales from the list abovi by checking <br /> the approprlate box(es). At least one file type MUST be selected. Fax o 209 464-0138 or mail to the <br /> address indicated above. <br /> 2. Eula will Ratify the applicant if any EHD files exist. An appointment for review will be confirmed 4 <br /> approximately five business clays but no later than ten(10)days after receipt of application. The files E <br /> will he held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that Is actively being worked on by EHD staff-May not be immediately available for review. A new <br /> application may be submitted when the file Is available. <br /> 4. Any file not returned In the same condition as released will be reorganlxed'by EHD staff at the expense <br /> of the applicant. Future file reviews by tits same applicant may require a$ST_00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confrmed with EHI I staff. <br /> 6. Applications received after 3;00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME. <br /> ' I <br /> DATE CONFIRMED PHONE FAX INITIALS _. <br /> REVIEWED YES NO REVIEW DATE .-- ' <br />