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5/2002 10:59 FAX W002/002 <br /> DATE"COVED EHD LOG NUMBER <br /> �. SAN JOA,.4 JIN COUNTYPUBLIC HEALTH SE,.,/ICES <br /> ENVIRONMENTAL HEALTH DIVISION -9i)z <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> _ (209) 468-3420 <br /> (PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT / ""'�� ! '°C Q`� BUSINESS/AGENCY <br /> ADDRESS <br /> /3ys <br /> PHONEFACSIMILE SEP 0 a 2002 <br /> Y _ ____— <br /> JVI��r �l�i` <br /> TENTATIVE TIME NT HEALTH APPOINTMENT DATE � <br /> (Please WZ— ;ETQUT <br /> ho to of app tion subml F 1T' ERVICES <br /> 13 CHECK BOX TO EXPEDITE REQUEST- R SID IN BUSINESS DA C L <br /> SIGNATURE OF APPLICANT DATE —7) - <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> cocher 0r Pk0e ;,c fir:•e Goy ,�.Kt A�r� �C - <br /> APN-44, /hw,4etw Gf} <br /> rAn�c n /399 <br /> u 7OD CA <br /> NN Acco -4 O /7// ese m; to 4ve--,- <br /> nn <br /> 011 <br /> ENVIRONMENTAL HEALTH DIVISION FILES SEP 7 2 2002 <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> �THER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOUP WASTE VEHICLE <br /> �FHANDERGROUND TANK(MONfTORING/REMOVAL) O DOG KENNEL WASTE GENERATOR 07 C3 DAIRY <br /> ARDOUS CHICKEN RANCH CIPKG TREATMENT PLANT <br /> 13 TIERED PERMITTED FACILITY ❑ MOTEL/HOTEL C3 PUMPER TRUCK/YARDlGNEM TOILETS <br /> ❑ TATTOO/BODY PEIRCING <br /> ❑ POOLISPA - ' ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ 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 be selected. Fax to (209)464-0138 orail to he <br /> address indicated above. <br /> 2. END 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 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 applicant, Future file reviews by the same applicant may require a $87.00 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 /> EH H 14 X1107/00 <br />