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`I-D 6-2001--1j8°.ilrf7 T0. 1925940%32 P.01 <br /> `� L f1iU lU.Iii1MLLLH <br /> I.- SAN JOAQUIN COUNTYPUBLIC HF-ALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION S�� �1 <br /> APR 1 7 ?001 304 EAST WEBER AVFNUE,THIRD FLOOR 4 V <br /> STOCKTON CA 85202 <br /> ENVF. ((I P,ri.,'� 1 HEALTH (209)463-3420 <br /> I <br /> PERT ^,E� PUSLIC RECORDS RELEASE APPLICATION <br /> APPUCANT f�L,Efi(T%!� f'Qblsll�NrA�uslNEsmAaeNCY �Q c a/� cy/S�su �/�N��' I/��'. <br /> ADDRESS <br /> PHONE L/S[= L ' FACSIMItF <br /> I TENTATIVE'APPOUITMEM DAT'f zQ /�! TIME <br /> J OV <br /> (Pteaeo give 7 to l0 tncstness c ftpm date of appilmon Z=Mttal) <br /> 6&11r5 ,2,Z,4 <br /> CHECK BOX TO EKPEDf r REQUES�T—$$37.00 FEE-REQUEST PROCESSED <br /> 1 0 INESS DAYS <br /> SIGNATURE OF APPLICANT v G r $'�—tet--� DATE <br /> FILE ADDHFUS THIS EIDE EHO STAFF USE ORLY <br /> PROGRAM ELEMENT3 SQARCH <br /> j G S S UC d 2 <br /> S #9'b I /V � S ree r§N <br /> 7 '12TtrI�4 vC, 0 T L szG <br /> ( (u • 90N CKTiZd 3sa4_�1w <br /> LirV,a .4 IrC K B C Ile 100 11.4i4,m �y 59 <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> NDEROROUND TANK(USTf CLEANUP SITE(L OP) Cl HOUSNO ABATEMENT " LID WAUTF FACILITY <br /> W,GTktER Cl1'ANUP SffE{NON{OP) ❑ FOODFACILRY ar UD WASTE VEHICLE <br /> (�,IYNOEfiOR0UN07ANK(NONfTOR1NOJREMOVAL) P DOG KFNNEL ❑ DAIAY <br /> d' AZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> I TM IERED PERLU7TFA FACILITY ❑ MOTELHOTEL C7 PUMPER TRUCK/YARWCHEY TOTS <br /> ❑/TATTDOJBODY PEIRCWG O POOUBPA 0 LAND USe APPLICAMN SITES <br /> Dr MAE'! ALWASTEFACfLITY 0 PUNIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> t. List up to ten addresses in the space above. Select the type(S)of files from the list above by checking <br /> the appropriate box(as). At least one file type MUST be selected. Fax to 12081464-0138 or mall to tris <br /> a,tl_drep Indicated above. <br /> j 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 tiles <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 being 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 retumed In the same condition as released 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 dates must be confirmed with EHD staff. <br /> 6. Applications recstvid after 3:00 pm wili be processed the next business day. <br /> i <br /> I <br /> i <br /> CONFIRMED APPOINTMENT DATE TREE <br /> j DATE CONFIRMED PHONE FAX INITIALS <br /> I <br />