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SAN JOAQUIN COUNTYFUBLIC HEALTH SERVICES 0��.! <br /> ENVIRONMENTAL HEALTH DIVISION 00/ <br /> 069 <br /> EAST WEBER AVENUE, THIRD FLOOR <br /> STOCKTON CA 95202 ^ PY(209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT dASISY 7V-ij5EV [BUS L\E-S1AGENCYLNC 60 TNP, <br /> ADDRESS CU 3 <br /> PHONE 2.0"1-a3! - 0610 FACSH,'.1LE --O <br /> TENTATIVE'APPOtrlTMENT DATE TIME <br /> (Please givo 7 to 10 bush=3 days ievm Cate of applicivon sLSmittai) <br /> 71 CHECK BOX TO EXPEDETE REQUEST->78.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT �Lc� ��� _ DATE --al-3460-- <br /> FILE ADDRESS <br /> LS 1 NONE <br /> f p <br /> f 16o- L` o /VO UL ) �y <br /> r S- N AJE <br /> -G A/6 NZ <br /> I N O rVSL I � i <br /> I 13e-?r-v 3v o L NCa� <br /> DIEV12QUOL 100 11600 <br /> ENVIRONMENTAL HEALT14 DIVISION FILES <br /> iff UNDERGROUND TANK jus r)CLEANUP SITE(LOP) C I?GUSLyG AEATE:MENT 9 50UD WAST=FACILITY <br /> 0 OTHER CLEANUP$iT ;NON-LOP) 0 FOCD FACILITY it SCUD WA5TE VEHrCLF <br /> FS iJvDERGROUND TANK 1tt10NITOR:Nc3/REMOVAQ 0 DOG KENNEL A DAIRY <br /> 0 KAZARDOUS WA$Yy GENERATOR ■ CHICKEN RANCH # PKG TRE-ATM EN'T PLANT <br /> * TIER:o P.Et yrn-ED FACJUfTY ❑ MOTEL/H07EL A PUMPER TRUCK'YAFtD/CHEM TOILETS <br /> ❑ TATT001DODY PEJRCi!SG ❑ POCLSPA ■ LAND USE APPLICATION SITES <br /> ❑ MEDICAL.WASTE FACIUTY It PUBLIC WATER SYSTEM 50 OTHER(PLEASE SPECIFY ABOVE) <br /> �. List up to ten addresses in the space above. Select the typs(s) of files from the Fist above by checking <br /> the appropriate bOX(es). At least one file typo MUST be selected. Fax to (2G3)464-0138 or mzil to the <br /> address indl�ated above <br /> 2 EHD will rtotlty the applicant if any EHO files exisL An appointment for review wi!I be confirmed <br /> approximately five business days but no later than ten (10) days after r"eipt of appliGztion. The files <br /> will b4 held for a maximum of five business days for review. Appointments shauld be scheduled <br /> accordingly. <br /> 3_ A file that it actively b-cing worked on by EHD staff msy not be immediately available for review_ A new <br /> appfication may be submitted when the fila is available, <br /> 4. Any file not returned in the same condition as released will be reorganized by E.HO staff at the expense <br /> of the applicant. Futuro file reviews by t1he same applicant may require a $78.00 deposit prior to review. <br /> 5, 'TENTATIVE appointment dates must bn confirmed with EHD staff. <br /> S. Applications receivr:d after 3:00 prn will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE. �. TIME <br /> l <br /> DATE CONFIRMED <br /> I'1-iOiVE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> k QO id o7101'� — � <br /> TMJ T rtW P.02 <br />