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08/28/2002 16:53 209-79-2225 MODESTO ATC - RAGE 01 <br /> .............. *41le \4e <br /> SAN'JOAQUIN COUNTYPUBLIC HEALTH SERVIC " c' <br /> ENVIRONMENTAL HEALTH DIVISIONVFN <br /> � <br /> 304 EAST WEBER AVENUE,THIRD FLOOR ��� <br /> STOCKTON CA 05202 <br /> (209) 468-3420 AUG 2 9 2002 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANTr(y4 _BUSINESS/AGENCY_ �� E pFeMITISERVICES <br /> ADDRESS I A�,rtJ\V'< < SJ:1< ID to 71)S-/ <br /> PHONE � ,� - 27 / FACSIMILE ZQ"t S •- Z2-L <br /> TENTATIVE*APPOINTMENT DATE- 9 TIME <br /> (Plcasp Vivo 7 to 10 business da s from to of applieallon submittal) <br /> ED �,, ' <br /> CHECK 80X TO,[JCPEDITE REQUEST-$07.0YFE 5T PRO SSED 1N 7 BUSINESS BAYS - <br /> SIGNATURE OF APPLICANT �/L►�� �� � DATE <br /> FILE ADORLSS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENT$SEARCH <br /> I <br /> 13 <br /> 1(" <br /> z'3 W . �.)o.sl�. �o�• s <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT d SOLID WASTE FACILITY <br /> �q OTHER CLEANUP SITE(NON-LOP) O FOOD FACILITY ❑ SOUD WASTE VEHICLE <br /> Q UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> ❑ HAZARDOUS WASTE GENERATOR O CHICKEN RANCH O PKG TREATMENT PLANT <br /> ❑ TIERED PERMITT 0 FACILITY O MOTEUN'OTEL ❑ PUMPER TRUCKIYARD/CHEMTOILETS <br /> ❑ TAT 001800Y PIJIRCING ❑ POOL/SPA -1 ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WAST(`_FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ton addresses in the space above. Select the type(s) of files from the list above by chocking <br /> the appropriate box(os). At least one file type MUST be selected. Fax to f209) 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 bcinCI 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 rclsasad 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 datos 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 FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE . <br /> an <br /> WA <br /> roo - <br />