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FROM : Ge it FAX NO. : 2095690295 <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES WG 0 1 2002 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR ENVIRONMENT HEALTH <br /> STOCKTON CA 95202 PER VI L <br /> 209 468.3420 <br /> � ) ION <br /> PUBLIC RECORDS RELEASE <br /> APPLICAT <br /> �1 yj�G� BUSINESS/AGENCY �� Q <br /> APPLICANT , <br /> ADDRESS g/3' �G'7V ::n-,7,f N PSTN <br /> PHONE �v FAdSIMILE„ 6 �---. <br /> TENTATIVE'APPOINTMENT DATE TIME <br /> (please plus 7 to�N�i da!�V 213 PIIS on submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$89.00 REQUEST PROCESSED IN 3 B INE DAYS <br /> DATE <br /> SIGNATURE:OF APPLICANT <br /> FILE ADDRESS 7NIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELLMENTS SEARCH <br /> ENVIRONME=NTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> p SOLID WASTE VEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) O FOOD FACILITY <br /> D DOG KENNEL O DAIRY <br /> UNDERGROUND TANK(MONrrORING/REMOVAL) � CHICKEN RANCH C4 PKG TREATMENT PLANT <br /> HAZARDOUS WASTE GENERATOR ❑ PUMPCR TRUK/YARDICHEM 7OILETS <br /> ❑ TIERED PERMITTED FACILI- ❑ M KEEN AN Y TEUHO D LAND USE APPLICATION SITES <br /> O TATTOO/6ODY PEIRCING O POOUSPA p PUBLIC WATER SYSTEM O OTHrR(PLEASE SPECIFY ABOVE) <br /> 0 MEDICAL WASTE FACILITY <br /> 1, List up to ten addresses In the space above. Select the type(s)of fibs from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to 209 464-0138 or mail to the <br /> r address indicated above. <br /> 2. EHD will notify the applicant if any EHD files exist. An appointment for review will be <br /> The files <br /> confirmed <br /> approximately five business days but no later than ten (10) days after receipt of application <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 bl2in0 worked on by EHD staff may not be immediately available for review,, A new <br /> application may bo submitted when the file is available. <br /> 4. Any file not returned ill 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 $89.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> G. 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 /> •n Il l�n� <br /> o — <br />