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.1 '02 FR1 13:45 FAX 19259469968 ERMWEST WC 002 <br /> .. SAN JCOUIN COUNTYPUBLIC HEALTH SAVICES r'n toeuw"en <br /> 0 0 ENVIRONMENTAL HEALTH DIVISION <br /> v 304 EAST WEBER AVENUE,THIRD FLOOR �nJ <br /> ' STOCKTON CA 852112 U <br /> (209) 468.3420 <br /> PUBLIC RECORDS RELEASE APPLICATION NOV 0 1 2002 <br /> APPLICANT�/}L1f��'T�9la=vim I IA-f� 13USINMSIAGENCY ENVIRONMENT HEALTH <br /> PHONE 'i-777'I rr�: 7Z t,f- I �,� r� t� A/AL Tr676cv t^ RVICES <br /> PHONE 9Z`�"9y6 -Oy� �'1�FAL�sIMILE_ _ �91Z�'9y6 <br /> TENTATIVE`APPOINTMENT DATE Q2✓E� 7-j5yz I�.�I Z TIME <br /> (Please ebe 1(a 10 buslnosa days from dale o!application subMI(M) <br /> CHECK I3OX TO EXPEDITE REQUEST�$09.00 FEE-REQUEST PROCESrEy0J U51 DA J <br /> SIGNATURE OF APPLICANT �V/`` (1 ATE <br /> F0.@ ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> i <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> M OTHER CLEANUP siTE(NON.LOp) O FOOD FACILITY ❑ SOLID WASTE VEHICLE - <br /> .Xj UNDERGROUND TANK(MONRORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> DA HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH O PKG TREATMENT PLANT <br /> Q TIERED PERLiITTED FACILITY ❑ MOTEUHOTEL ❑ PUMPER TRUGK1YARWCHEM TOILETS <br /> ❑ TATTOOIBODY PEIRCiNG OLISRA— 0 LAND USE APPLICATION srMS <br /> ❑ MEDICAL WASTE FACILITY / p BL1C Wg55T6R SYSTEM PLEASE SPECIFY ABOVE) <br /> i, List up to ten addrosses In the space above.FSelect he typo(sTviLfiLitaIrom the list above by ehecking <br /> the appropriate bOX(es). At least one file typo MUST be selected. Fox to (2091464-01 N 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 ton (10) days atter recelpt of application, The files <br /> will bo hold for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly, <br /> 3. A rile 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 /> A. Any fila 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 /> 5. 'TENTATIVE appointment dates must bo confirmed with EHD staff. <br /> 6. Applications received after 3;00 pre will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE. TIME <br /> DATE CONFIRMED _ PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE ^ " <br />