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12/07/2001 11:42 9092733346 OFFA:EEMAX N 0527 EH�LOGNUNeEa AGE 01 <br /> l�1 <br /> GATE aECENGD <br /> SANAQUIN COUNTYPLJBLIC HEALTH ERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> )� 304 EAST WEBER AVENUE,THIRD FLOOR / lJ <br /> STOCKTON CA 95202 <br /> . (209)468-3420 <br /> (� PUBLIC RECORDS RELEASE^APPLICATION <br /> APPLICANT ` ETr_,P_ o\V\00c_�e BUSINESSIAGENCY <br /> ADDRESS �r�^ \\ I�GRTN �Vc SIOE R'JE \K\A't'C� 7�CP% ) -!S J7 <br /> PHONE(D�5a:7T'D-CD 5717 FACSIMILE—( 1�-��—�,e-s-•�� <br /> TENTATIVE"APPOINTMENT DATE l�� �QU2 TIME <br /> (Please Diva 7 to 10 business days from date of application submittal) <br /> ❑ U'`J'� <br /> CHECK BOX TO EXPEDITE REQUEST-$70.00 FEE-REQUEST OC 'SSED IN 3 BUSINESS DAYS \ <br /> SIGNATURE OF APPLICANT -rk � e DATE <br /> R. FILE ADDRESS - - - -- - <br /> Cpt�3"C1N��1'T�_ GtZALtJ Cr�iv�aPNY <br /> S a �4P eLRN 2D Fttt CA <br /> \N Ot�•c "CQVc1G1nY.o AN <br /> � oPA rGlK1:�L�\1Y1 GomPaNY � � � G <br /> �-�3 NAVY OnauF � g'cor�'ro+� <br /> V � l '3TO CX-TO e2 ✓� L� <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> NDERGROUND TANK(UST(CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOPI 11 FOOD FACILITY 13SOUD WASTE VEHICLE <br /> 6T UNDERGROUND TANK(MONITORING)REMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> ❑ HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCKrfARDICHEM TOILETS <br /> ❑ TATTOO/BODY PEIRCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM 0 OTHER(PLEASE SPECIFY ABOVE) <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 he selected. Fax/o (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 flle that is actively being worked on by EHD staff may not be Immediately available for review. A neer <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 INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> Eli W 14 UVOLW - - ---- <br />