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09/16/2005 113::30 2094728f-' PAGE 02/02 <br /> U F'F D 464@1.38 A—✓ ENVIRONMENTAL HEALTF%� PAGE 02 <br /> w9 L��u�w� <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES � <br /> SEP 6 2005 4 ENVIRONMENTAL HEALTH DIVISION j <br /> 304 EAST WEBER AVENUE,THIRD FLOOk <br /> ENVIROWI.IENT HEALTH STOCKTON CA 95202 <br /> (209)468-3420 <br /> PE,,., fi��t RVICE� PUBLIC RECORDS RELEASE APPLICATIO <br /> APPLICANT ViCk VUS#& 1A*ENCY C3) <br /> ADORES572 <br /> 1�� � <br /> 0_FACSIMILpEE - <br /> TENTATW APPONTtMM DATE/ l _ TIME . <br /> (mean*ems+7 to 40 bin!. sa&0 from date of apptlaation submtttaq upt + <br /> Citt:CK BbX To EXPEDITE REQUEST 0.00 -R CESSFD IN 3 811S(NESS DAYS <br /> SIGNATURE OF APKICANT DA <br /> TE <br /> FILE Ala S THIS SLOE EMP STAFF USE OHLY <br /> PWMItAM ELEMENTS SEARCH <br /> I'✓tiPX L:05 T <br /> PrEmbiZz <br /> rGv l_uS <br /> Ll <br /> �? V <br /> EWRRONMENTAL HEALTH DIVISION FILES Ll <br /> ❑ HOUSMS AAATEMENT d SOLID WASTE FACIt1TY <br /> tlNOERGROVND TANK(UST)CLEANUP SITE(L�'? O FOOD FACILITY 0 SOLM WASTE VEHICLE <br /> R CLEANUP SITE(rlW"P) 0 D4G tC£Nr[EL ❑ DA[6tr <br /> 7U=AZART)M <br /> RGROUND TANK(MONTTORiIfGIREMt>ti►�-1 ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ WASTEGO'KRATOR ❑ moTELti-IOTEL ❑ PUMPERTRuCKrYARMHEWTOILETS <br /> ❑ TIERED PERNTTTED FAC7U''Y D poOtJSPA 0 I.AMD USE APPLICA'nOM SrTtS <br /> ❑ TATTOOIBODY PEIRCING ❑ PUBLIC WATER SYSTEM 0 OTHER MLZASE SP'ECIFT ABOVE) <br /> Q mEDIGAL wAs7E FAG[Lrty <br /> 1. List up to tent addresses in the spsce above. Select the types)of files from the list above by checking <br /> the appropriate box(eS). At least one file type MUST be selected. FBx to 20!91464-0138 or mail to the <br /> Qddtess indicated 2Kt1�OVe. <br /> 2. EHD will notify the applicant N any EHD files exist. An appointment for reviow will be confirmed <br /> approximately five bulginess days but no tater than ten('10)days aftsr 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 Ve that is actively being worked on by ENE)sftfr may not be immediately available for revises. A new <br /> applicattion may be submitted when the fife i$avpirable. <br /> 4. Any file not returned in the same condition as rejeas. Will <br /> be oroanized re as d 9y00 11)stdepoaff <br /> pr Orta rc}visat the <br /> of the applicant_ FuWM file reviews by the came applicant <br /> W. <br /> 5, "71V <br /> ENTATE AppointmIent dat"must be confirmed with EMD staff. <br /> g. Applications received after 3.00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE. TIME <br /> ( DATE CONFIRMED <br /> FAX INITIALS _ <br /> REWEWE:D YES NO P"EW DATE <br />