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ti <br />07/15/2002 14:45 <br />V11 4 KCl.LJVtL <br />20941 '18 AGE STOCKTON PAGE 01/01 <br />END LOG NUMMA <br />SAN .,JAQUIN COUNTYPUBLIC HEALTH SERVICESMOMOVED <br />ENVIRONMENTAL HEALTH DIVISION <br />304 EAST WEBER AVENUE, T O R <br />STOCxTQN CA 95202 ,- `n 'UL 16 2002 <br />�.. <br />(209) 466.3420 '� y "} <br />PUBIC RECORDS RELEASE PPL ICATIOWNAONMENT HEALTH <br />TENTATIVE* APPOINTMENT DATE <br />(Please give T <br />CHECK BOX TO EXPEDn'I; RE <br />SIGNATURE OF APPLICANT <br />M 21111 <br />�1.�7f����IMNI'�►/IUll�l �T r ��� <br />ENVIRONMENTAL HEALTH DIVISION FILES <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) <br />❑ HOUSING ABATEMENT <br />❑ SOLID WASTE FACILITY <br />OTHER CLEANUP SITE (NON -LOP) <br />O FOOD FACILITY <br />❑ SOLID WASTE VEHICLE <br />UNDERGROUND TANK (MONITORING/REMOVAL) <br />❑ DOG KENNEL. <br />❑ DAIRY <br />HAZARDOUS WASTE GENERATOR <br />❑ CHICKEN RANCH <br />Q PKG TREATMENT PLANT <br />TIERED PERMITTED FACILITY <br />❑ MOTEUHOTEL <br />❑ PUMPER TRUCK/YAR.D/CHEWTOILETS <br />❑ TATTOO/BODY PEIRCING <br />❑ POOL/SPA <br />❑ LAND USE APPLICATION SITES <br />❑ MEDICAL WASTE FACILITY <br />❑ PUBLIC WATER SYSTEM <br />❑ OTHER. (PLEASE SPECIFY ABOVE) <br />0 <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) 464-0138 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 flies <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 new <br />application may be submitted 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 $78.00 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 1NITIAL,S <br />REVIEWED YES NO REVIEW DATE <br />EH 00 tI Ot/aslOa <br />