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01/08/2002 MON 12;50 FAX X16 5654356 C�OOI1001 <br /> ars riot 1o15,4 lu:Rtl 4 :119 ENVIRa44+ �ITi�f=ALTH PAGE 01 <br /> w AN JOAQUIN COUNTYPUBLIC HEALTH SERVICES � �'4ocrlural� <br /> >;NVIRONMENTAL HLALTH DIVISION <br /> 304 EAST WESER AVENLII=,THIRD FLOOR ' <br /> STOCKTON CA-95202(209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT '!Q_77�c 15.Y.,.,.u <br /> --euspresslAGeHcir y �. <br /> ADDRESS / . <br /> PI-101`4E R — FACSIMILE <br /> n•TENTATIVE*APPoirnmctrT DATE TiMC .F <br /> C� (Plensa Dive T t i s 8pp11 submittal) <br /> 1 <br /> CHI~.CK BOX TO EXPEDI'TE REQUEST- .00 F qU 5T OCES jf 3 iNES <br /> ' K F — S DAYS <br /> ,'SIGN 'e OF APPLICANT - DATE <br /> F1LE ADDRESS THIS SIDE~emi STAFF USit ONLY <br /> D PROGRAiN/ELJEMPNTS SEARCH <br /> 52 <br /> Livia <br /> Z <br /> W <br /> ar <br /> ENVIRONMENTAL HEALTH DIVISION FILE$ <br /> [is UNDERGROUND TANK(UST)CLEANUP$ITE(LOP) 0 HOUSING ABATEMERT ❑ SOLID WASTE FAmi rrY <br /> ❑ OT14ER CLEANUP 517E(HON.LOP) ❑ FOOD T:ACiLrTY ❑ SOUD WASTE VEHICLE <br /> UNDERGROUND TANK(24ONrrck[tGIR£MOVAL) CI DOG KENNEL ❑IP DAIRY <br /> HAZARDOUS WASTE GENERATOR0 CHICKEN RAllait O PKG TREAYMeNT PLANT <br /> C1 TMfto PERMITTED FACILITY Q MOTELA 40TEL Ll PUMPER TRUCK/YARWCHEM TOILETS + <br /> ❑ TATTOOlnODY pEfRCTNtt Ll •POOLMPA n LAND USE APPLIONnON Sn"ES <br /> EJ MEDICAL WASTE FACIL" O PUBLIC WATCR SYSTEM E3 OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to tars 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 /> , <br /> 2. EHD will notify the applicant if any EHD flies exist, An appointment for rAview will be confirmed <br /> approXimately five 13USiness days but no later than ten(10)days after roce)pt of application. The files <br /> wtll be held for a maximum Of five businosS 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 applicranL Future file reviews by ttte same applicant may require a$89,00 deposit prior to review, <br /> 5. 'TENTATIVE appointment dates must be contlrmed with EHD staff. <br /> .6. Applications received after 3:00 pm will.be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE. 'GIME <br /> DATE CONFIRMED PHONE FAX •INl•T'1AL•S <br /> REVIEWED YES NO REVSDnI nA'CE—., ..� <br /> nninnr <br /> Post-ft'Fax Note 7677 D"IB7 r�. o°ae1lxrs� <br /> To From <br /> 8,U dA A <br /> . CAJD6Pt• rf�0 � I <br /> rnene (R y'- Zo <br /> c..•.• r f., r-. r 11 �.`�Ir� Fax I <br />