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02/11/03 TUE 14:29 FAX 925 253 4985 TREADHBLL.& ROLLO { � Z001 <br /> I;bi 1brei <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> .j <br /> ENVIRONMENTAL HEALTH-DIVISION i +J y 304 EAST WEBER AVENUE,THIRD FLOOR 51' <br /> k ti k STOCKTON CA 55202 <br /> (209)46a•,3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT OAA lac` C <br /> - ��S 9USIHESSIAGENCY_ <br /> A00RE55 ,._ - 1Aeo�Y� 4i RA1�,�i <br /> PHONE• T FACSIMILE _ RL�S �1 <br /> TENTATIVE"APPOINTMI~rrl:oAYc____Cho LO./()I TIME I�p0 •- ���Q-t73 � �� <br /> (Please give 7 to 10 bualnoss days from dale at application su6mi[Ia!)" <br /> CHECK BOX 70 EXPEDITE REQUEST w 9.00 FEE UEST PROCESSED IN 3 BUSINESS DAYS u <br /> - SIGNATURE OF APPLICANT -__ - DAT I; • l! <br /> FILE ADbRIESS THIS SIDE END STAFF USE ONLY <br /> PROGRAM ELJE04 ENTS SEARCI•I <br /> lw <br /> y"do Tr arc r <br /> 5� W�s� �• � - � ' <br /> 4-74 <br /> .2M15 <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> 14 UNDERGROUND TANK(UST)CLEANUP$tTE(LOP) Cl HOUSING ABATEMENT Q SOUK WA.1jTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) D FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> j UNDERGROUND TANK(MONITORINGIREMOVAL). Cl DOG KENNEL D DAIRY <br /> HA7ARDOUS WASTE GENERATOR O CHICKEN RANCH Cl PKO TREATMENT PLANT <br /> TIERED PERMITTED FACILITY O MOTCUHOTEL M PUMPER TRUCKFYARDICNEM TOILETS <br /> ❑ TATTO01000Y PCIRCIPNG ❑ POOUSPA -CI LAND USE APPL1CA170N SITES <br /> 4 MEDICAL,WASTE FACILITY ti 0 PUBLIC WATCR SYSTEM Cl OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to tun addresses In the space above. Select the type($) of files from the I15t at]ove by checking <br /> the appropriate box(es). At least one file type MUST.bo selected. Fax to 209 464-0936 or mail to the <br /> �^ address ind-hated above. <br /> 2. EHO 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 (90)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 Elie 11,3111,actively blrin0 worked on by EHO 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 )h the same condition as released will be reorganized by EHD staff at the expense <br /> 4. of the applicant. FutUre fele reviews by tho same applicant may require a $59.00 deposit'prlor to review. <br /> 5. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> i <br /> .6. Applications received after 3.00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE. <br /> TIME <br /> a <br /> DATE CONFIRMED PHONE FAX " INITIALS <br /> REVIEWED YES NO REVIEW DATE P+"� <br /> TO -Jnw.J LIi1F17L1 APTabQh Tb:AT 7.L1a7/7.T.1TT <br />