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Feb 06 04 12: 23p KRf37AN & ASSOCIATES 916 5r-4 2222 p.3 <br /> 11/04/2002 10:36 4640138Nopol ENVIRONMENTAL HEALTF-� PAGE 02 <br /> 1 604 11.14 L.,Lw%u E�fD LO(:NU411'�t <br /> 'UIN COUNTYPUBLIC HEALTH SER,, <br /> ME VE SAN JOE NV RONMENTAL HEALTH.O VISION CES <br /> IN <br /> Imo} 304 EAST WEBER AVENUE,THIRD FLOOR <br /> FEB 0 6 2004 STOCKTON CA 95202 <br /> (209)468.3420 <br /> ENVIRnnl d na €A I TW PUBLIC RECORDS RELEASE APPLICATION <br /> P �� �� �n'G� /� BUSINL•SSJAGENCY�Qi�I�glyt/ �f �SS�O/G//�7�5 <br /> ADDRESS <br /> p G� 4g<, _ 2eClleQ��W <br /> PHONE / '.Sri����OD FAde[MILE <br /> TENTATIVE'APPOINTMENT DATE TIME <br /> (Please give y to 10 business days from date of lippllcation submittal) <br /> CHECK BOX TO EXPEOrfE REQUEST-S ROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> o,PT />h — C E.f/7 Z& tea/ <br /> i <br /> i • <br /> l . Q <br /> ENVIRONMENTAL HEALTH DIVISION FILES gt yQ� <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) CI HOUSING ABATEMENT >1CSOLID WASTE FACILI <br /> i OTHER CLEANUP SITE(NOR-LOP) ❑ FOOD FACILITY 0 SOLID WASTE VEHICLE <br /> KUNneRGROUND TANK(MONRORINGIREMOVAL) O DOG KENNEL O DAIRY - - <br /> H"000S WASTE GENERATOR 0 CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> 'TIERED PERMITTED FACILITY 0 MOTELIHOTEL 0 PUMPER TRUCKIYARDICHEM TOILETS <br /> 0 TATTOO/BODY PEIRCING ❑ POOLISPA D LAND USE APPLICATION SITES <br /> M MEDICAL WASTE FACILITY O PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY AOOVE) <br /> _ 1. List up to ten addresses in the space above. Select the types)of files from the list above by checking <br /> the appropriate box(es). At least one filo type MUST be selected. Fax to(209)464-0130 or mall to the <br /> address indietted above. <br /> i 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 ton(10)days after receipt of application. The files <br /> wilt be held for a maximum of five business days for review. Appointmonts should be scheduled <br /> accordingly. <br /> 3. A fife that.is actively bNing worked on by EHD stair may not be immediately available for review. A new <br /> application may be submitted when the file is available. <br /> 4. Any rile not ratlirnod in the same condition as released will be reorganized by EHO staff at the expanse <br /> or the applicant. Future tole reviews by tho 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. , vim. F <br /> I <br /> CONFIRMED APPOINTMENT DATE, TIME ' <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br />