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,..., _-11ar 28 03 04: 49p KRPn & RSSOCIRTES <br /> 916 --4 2222 p. 2 <br /> bm n nwuryyn the\nn nwn},x <br /> r SAN JOA.JUIN COUNTYPUBLIC HEALTH SER_.CES <br /> - i <br /> i ENVIRONMENTAL HEALTH-DIVISION I �� <br /> v <br /> 304 EAST WEBER AVENUE,THIRDFLO <br /> FLOOR ' <br /> MAR 2 8 2003 STOCKTON CA 95202 <br /> (209)408•3420 <br /> ENVIRuN ,IlEhi IHENLPUBLIC RECORDS RELEASE APPLICATION <br /> ;v l <br /> AP7NJCANT �'SppIL _ V/C k ,�//40/.BUSINESSfAGENCY <br /> �� K�� �r3/r�l�� AssOciFh?Z� <br /> ADDRESS `S Dao /"/PI�•LC /7yU� SACI/'.t7//��.v�/� S'•S�O.J.(_. <br /> PHONE 1;114 X41 too FAdelMILE <br /> TENTATIVE'APPOINTMENT DATE TIME <br /> IPleas*alve Y to to business days from date of AprAloatlon snbmll(01) <br /> oF <br /> CHECK BOX TO EXPEDITE REQUEST• •00 F-E QUEST PROCESSED IN 3 BUSINESS DAYS U n ' I <br /> SIGNATURE OF APPLICANT ��ny "_^— DATE �� — <br /> FILE ADDRESS THISSIDE ENI)STAFF USE INJLY <br /> PROGRAM E1.EMENYS::EARCH <br /> ! E ,6719./-ZoY -- -- <br /> 65- H45T <br /> Fo ! C 7 — --- <br /> RVIAI '— <br /> MO <br /> E!t tt/oa WAr o D I1/ C <br /> ilio X76 r- <br /> o /i/o lvAY <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> uNDERGROUND TANK(U5T)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT 0 SOLIIDJ WASTE TE FA01 ITE <br /> ❑ TY <br /> OTHER CLEANUP SITE(NON-LOP) O FOOD FACILITY <br /> ❑ DAIRY <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) O DOG KENNEL O PKG TRL'ATMENT PLANT <br /> H"DOUS WASTE GENERATOR 0 CHICKEN RANCH 0 PKG TRI,TRUCKIYARDICHENTDILETS <br /> O TIERED PERMITTED FACILITY 0 NOTELMOTEI <br /> ❑ TATTOOJBODY PEIRCING D POOVSPA LAND USE APPLICATION SITES <br /> D MEDICAL WASTE FACILITY O PUBLIC WATER SYSTEM O pTHt:R(PLEASE SPECIFY ADOvr_) <br /> 1, List up to ten addresses in the space above. Select the types) of files from the list above by chocking <br /> the appropriate box(es). At least one file type MUST be selected. Fax m �l'47 n64-0'110 or mall to the <br /> address indicated abOXV, <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(1D)days after recelp't of appiication. The filos <br /> will be hold for a maximum of five business days for review. Appointments :should tie::chedulod <br /> accordingly. <br /> 0. A file that i5 actively Ming worked on by EHD staff may not be immediately available for review. A neve <br /> application may be submitted when the file is available. <br /> 4. Any file not returned in thl same condition as reloasod will bo reorganized by EHD sl3U at the expense <br /> of the applicant. Future rile reviews by the same applicant may require a $89.00 deposit prior to review, <br /> 5. `TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 8. 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 .., _';,g =– <br /> .� <br />