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SAN JOAQUIN COUNTYPUBLIC H, �, H SERVIi✓ <br /> ENVIRONMENTAL HEALTtfiIDWISION. <br /> f! L i) 2001 304 EAST WEBER AVENUE,THIRD FLOOR <br /> jn STOCKTON CA 95202 DSC 0 <br /> (209) 468-3420 <br /> PUBLIC RECORDS RELEASE'APPLI:CA _�'I� <br /> �OAPPLICANT LT&00 C, �/�-�r BUSINESS/AGENCY <br /> ADDRESS <br /> PHONE_ �H 9^O S ti FACSIMILE , <br /> TENTATIVE"APPOINTMENT DATE TIME <br /> (Please Hive 7 to 110/business days from dale of application submittal) <br /> I] CHECK BOX TO,EXPEDITE REQUEST.511 00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> )/SIGNATURE OF APPLICANT Ab110 J2 DATE /a <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> L ab <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) O HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> ❑ OTHER CLEANUP SITE(NON-LOP) O FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MON ITORINGIRCMO%4AL) ❑ DOG KENNEL ❑ DAIRY <br /> ❑ HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTEUHOTEL ❑ PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑ TATTOO/BODY PHIRCING O POOL/SPA O LAND USE APPLICATION SITES <br /> O MEDICAL WASTI!FACILITY ❑ PUBLIC WATE=R SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. 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(es). At least one file type MUST be selected. Fax to (209) 464-013'8 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 being worked on by EHD staff may not be immediately available for review. A now <br /> application may be sudmitted when the file is available. <br /> 4• Any file not returned 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 received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br />