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Jul 24 03 02: 46p P. 1 <br /> 07/24/2003 14:31 4640138 ENVIRONMENTAL HEALTF PAGE 01 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT 3q <br /> 304 EAST WESER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> ,JU 2 4 2003 (209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> pCAPP•.WtAfVyF GG-i'L1` t le-t" BUSINESS/AGENCY <br /> ADDRESS` \G�i�'�^/ C-0vA I- <br /> Z V•r �i <br /> PHONE I�G�SU J S-+j r: 4 ( FACSIMILE Np—) — <br /> TENTATIVE*APPOINTMENT DATE_.:R-IZ�S - �-/3 D TIME Q t <br /> (Plasae give 7 to lOrbusinets days fro date of application submittal) 1 <br /> a � <br /> CHECK BOX TO EXPEDITE REQU&S7-$88.00 FEE-REQUES <br /> T PROCESSED IN 3 BUSINESS DAYS. <br /> SIGNATURE OF APPLICANT �/ I c�L-. � DATE z 3 7' <br /> FILE ADDRESS THIS SIDE END STAFF U E ONLY <br /> PROGRAM ELEMENT EARCH <br /> C <br /> .A cl (,wgr <br /> 3 A E,usaq <br /> Fn <br /> Ile � <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT <SOLID WASTE FACILfTY <br /> VC OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY SOLID WASTE VEHICLE <br /> / UNDERGROUND TANK(MONITORING/REMOVAL) 0 DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> ❑ TIERED PERMrTTED FACILITY 0 MOTEL/HOTEL 13 PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑ TA'ITTOOIBOOY PEIRCING 0 POOV9PA /Im LAND USE APPLICATION SITES <br /> ❑ MEDIcAL WASTE FACILITY O OTHER(PLEASE SPECIFY) <br /> 1- List up to ten addresses in the space above. Select the type(s)of flies from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fg (209}464-0138 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 His that is actively being worked on by END staff may not be immediately available for review. A new <br /> application may be submitted when the fue 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$89.00 deposit prior to review- <br /> s. '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 AOO <br /> MATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> END tHI.9% <br /> y/;Cf200] <br />