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30 SECOP. PAGE 01/bl <br /> 07/28/2003 10:34 916861©3433 FIFTH FLOOD. PAGE 02 I <br /> Uit1112"1 '15:15 20` <br /> Llgl k FE6EPICD CNU LUQ NJmUUt <br /> SAN JOAQUIN COUNTYPUBLiC HEALTH SERVICES I <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 Ho <br /> J U l_ 8 'Z003 (209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT -T�nw�'t l' - �t� BUSINESSIAGENCY C� `r Yn � '�'''G• II <br /> ADDRESS D 1 4C�I <br /> PHONE t��(f°� Lo(,[� -f4�[? r .� ACSIMILr (2 <br /> a 1Q � �� `C 7�0� TIM[ <br /> TENTATIVE APPOINTMENT DATE L --..�—�— <br /> (Please 9(ve 7 to 10 ba3lrrOks days from tiate of appllaativn submittal) <br /> • <br /> 1 <br /> CHECK B0X TO EXPEDfTE <br /> d� <br /> RE ESTL-,T1817-101.101 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS 1 <br /> SIGNATURE OF APPt.iCANT REE <br /> - Q �4 DATE <br /> i <br /> FILE ADDRESS THIS sIDE FND STAFF USE ONLY <br /> PROGRAM ELEMENTS W. 9c" <br /> 3 r (itis TYQL C o q S3 �35� � <br /> I <br /> st AI <br /> L` <br /> ,/ s� t�; U <br /> ENVIRONMENTAL HEALTH DIVISION FILES I <br /> ■ UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> X OTHER CLEANUP SITE(NON-LOP) ^ �'AR-CO* 71 F000 FACILnY ❑ SOLID WASTE VEHICLE <br /> ❑ UNDERGROUND TANK(MONITORINGfREMOVAL) O POG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH 71 PKC TREATMENT PLANT <br /> ❑ <br /> C] TIERED PERMITTED FACILITY 0 M0 EUHQTLL ❑ PUMPERTRUGWYARDICHEM T=ET8 <br /> ❑ TIERED BODY PED FACTCINQ D POOLISPA ' ' Q LAND Use APPLICATION SITES <br /> In MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM M OT1-LRR(PLEASE 9PECiFY ABOVE) <br /> 1. List up to ten addresses in the space ahcve. 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)40-0130 or mail tv the <br /> addre 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. j <br /> 3. A file thet is actively being worked on by EHD staff may not be immediately available for roview. A new. <br /> application may be submitted when the fila is available, <br /> 4. Any file not returned in the same condition as released will be reorganized by EHO staff at the expense <br /> of the applicant. Future file reviews by tho Rami'•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:D0 pm will be processed the next business day. <br /> I <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DAT7=CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> CH 00 14 0=7100 <br />