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PHONE NO. 209 369 4226 May. ) 2083 Qi3: P <br /> ROM NOA Environmental 5AN JOAQUIN COUNTYPU13LIC HEALTH SERVICES � <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOC k ' <br /> MAY 1 7_003 STOCKTON CA 95202 <br /> ('209)468-3420 <br /> f�'► '. ... :iJ? i ,=-,�:�1� PUBLIC RECORDS RELEASE APPLICATION <br /> APPUCAHT cel tJ MUSINE'SWAGE?NCV <br /> ADDRESS LL iQmj1540;tVZ-rk,-P- Lied, ,6 <br /> PHONE•kbi -X-7-3701 FACSIfiALrn/2o A30—�' ey-* , <br /> TENTATIVE'APP09NTmewr DATE l L, c 71ktE _'�t✓-•a '�` S�a3 1 �� <br /> (Please give 7 to 10 buss from date of a ([cation tuin nlUM) <br /> Ys PP <br /> ❑ <br /> CHECK li OX TO EXPEDITE RE4UE:5T- EE-. ql}ES,T PROCESsEA IN 0 gIASINE.iS DAY.I• <br /> � <br /> SIGNATURE OF APPLICANT ��-- h7ATE `� 1 Ids <br /> FILE:ADDRESSTH4 SIDEEtID:9T.7U USE <br /> PRQGrtm e:�NTS SEARCH <br /> ( <br /> 27-6-0 z 9 S t'i33 <br /> ENVIRONMENTAL HEALTH WSION FILES <br /> Or UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 13 HOUSING ABATEMENT ET' SOLIV WASTE FIll MXrf <br /> OTHER CLEANUP SITE(NON-LOP) a FOOD FACILITY SS"SOLIt)WASTE VEHICLE: <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL C DJUR`f <br /> mr HAZARDOUS WASTE GENERATOR t3 CHICKEN RANCH C3 P1CC3 3 RF-A MI ENT PLAAIT . <br /> Or TIEREDPERmrrrEDFACIUTY M MOT"_EJHOTEL a PIJMPIiR7RtICKlYARDICH04TO:LETS <br /> 0 TATTOOIBODY PEIRCING 0 POO-JSPA C3 LAND'JSE MPLICA71ON SM <br /> 0 MEDICAL WASTE FACILITY t3 PUBLIC WATER SYSTEM 0 OTHE1I(PLEASE SPECIFY ABOVE) <br /> 1. List up to tan addresses in the space above. Select the type(s)of filen from the list above by clicking <br /> the appropriate box(es). At least one file tirpe MUST be selected. Fax t�,22 46"138 fir mail to the <br /> address indicated above. , <br /> 2. EHD will notify the applicant if any'END files exist. An appointment for review Nrill be Confirmed <br /> approximately five business days but no later than ten(10)days aftoe r ecolipt of application. The files <br /> will be held for a maximum of five businesa days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that[g actively being worked an by EHD staff may not be immi:dl ate[y available for review. Anew <br /> application may be submitted when the file,is available. <br /> 4. Any Elle not returned in the same condition as released will be reorganized by IEliD staff at the expense <br /> of the applicant- Future file reviews by the same applicant may regvin!a$139,00 cleposit prior to review. <br /> 5. "TENTATIVE appointment dates must be confirmed with EHD staff. <br /> G. Applications received after 3:00 pm will be processed the next busirle:s dory. <br /> I <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED _ PHONE FAX 1NfT"IA.LS <br /> REVIEWED--- YES NO REVIEW DATE _ <br />