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04/11/2003 08:29 209-579 ?5 ME)DESTO ATC PAGE 01 -- <br /> .. o (�{� �. VED <br /> R ` . __ SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION i <br /> APR 10 2003 304 EAST WEEER AVENUE,THIRD FLOOR <br /> STOCKTON CA!13202 <br /> ?V1r,i.:Nh4ENT HEALTH (200)468-3420 I <br /> qpAIT//SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT .I)Y O►.� A44\ SUSINESSIAGENCY klrcPC - <br /> ADDRESS III 1tQ-AAI• ?fitw, !IL^, . S`1.��4.. �, AA4r-w%1Q <br /> t _ <br /> PHONE Zy4 5, Z,'LZ.[ FACSIMILE_ V%301 5 `49 - -ZZ.ZS~ <br /> TENTATIVE'APPOINTMaNT OATS 44/ZT-I o3 TIME _ Q �E'c�" -03 <br /> (Please viva Y to 10 business days lrtWn dale of applicalla" ttai) <br /> Q CHECK BOX TO•EXPEDITE REQUEST-$87.00 FEE-REQUe5T PROCESSED IN 3 13USINCSS DAYS <br /> SIGNATURE OF APPLICANT .Ar VI /4-AkPAT[ `�I/11 '�3 <br /> FILE ADDRESS THIS SIOC EHO STAFF USE ONLY <br /> PROGRAM ELI3MENTS SEARCH <br /> t �0 1 d <br /> Mc<+ Z D S. - <br /> � <br /> 2 99 <br /> v5 .1�• rertvf �,c..l Q., <br /> o } (vdAP.4,AL� <br /> Q a _ M i� S <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> �UHOERGROUNO TANK tua r)CLEANUP SITE(LOP) O HOUSING ADATLMENT O SOUL WASTE FACILITY <br /> O OTHER CLEANUP SITE(NON-LOP) O 11000 FACILITY O SOLID WASTE VEHtCLt: <br /> O UNDERGROUND TANK(MONITORING/Ar-MOVAL) O 0OG KNNNEI M OAWY <br /> O HAZAROOU3 WASTE GENt{RATOR O CHICKEN RANCH O PKO TKRATME14T PLANT <br /> O TIER90 PdRNnTqO FACILITY O MOYEUHbTEL O PUMPER TRUCKfrARWCHEM TOILETS <br /> 0 TATTOQI600Y PWRCING . O POOUSPA O LANo 175E APPLICATm SRCS <br /> O MEDICAL WASTd FACILITY O Pusuc wATER sYsxam O OTHER(PLEASE SPECIFY AOOVL') <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by 'hocking <br /> the approtpriate box(es). At least one file type MUST be selected. Fax to 1,229)454-0138 or mail to the <br /> -tddress'indicated above. <br /> 2. EHD will notify the appilcant If any EHD files exist. An appointment for review will ho confirmed <br /> approximately five business days but no later than tbn(10)days 411.017 recolpt of application.-The files <br /> will be hold for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively beinfj worked on by EHD staff may not be immediately ravallable for roview. A nuw <br /> application may be submitted when the filo is available. ' <br /> 4. Any tits not returned In the same condition as released will be roorganixat(by EHD r4aff at the expense <br /> Of the applicant. Futurc file reviews by the same applicant may require A 507.00 dcpasit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHO staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE; <br /> TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE . <br />