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ROM NOA Env i ranrnenta 1 ,,, PHC3NE N0. 209 369 4228 M.5 y. 1.1 2003 @I3:42PM P2 <br /> ERM t,60 KuMEx <br /> SAN JOAQUIN COUNTYPU13LIC HEALTH�SE:RVICES � <br /> ENVIRONMENTAL HEALTH DJVIi Iopj <br /> V 364 EAST WEBER AVENUE,THIRD F=LOOR <br /> MAY 1. 5 2003 STOCKTON CA 93202 <br /> (-A;09)468-3420 qq <br /> PUBLIC RECORDS RELEASE APP L IC.ATJa <br /> APPUCMT !i' 11-LL), BUSINESS/AGENCY <br /> ADDRESS 5t"dJL2 L4Q• „_ i - w <br /> _ .,. <br /> PRONE � 0�-- 7� '} <br /> FACSI�1ILE 2AR 3��- E4�� <br /> TENTATIVE*APPOINTMENT DATE l c1 ° T >: 'T-6!)-'��`"` � ^_��.a?J 1 h� <br /> (Please glvo 7 to 10 bull -'z dAYS from slate of appuclan:iul,txiiti:+I <br /> ` <br /> CHECK HOX Tb ExAE RITE RE4UEST- EE CIUMT PROCESSED IN 3 BUS64E:3s DAY I a uOrl, <br /> i r .q+>LF <br /> � <br /> SIGNATURE OF APPLICANT DATE <br /> FILE:ADDRESS THIw SIDE CFF USE ONLY <br /> PRc1Gr3Am--jX f -NTS SEARCH <br /> to( mouick R"Coo <br /> ; ?'S700?'S700 alit <br /> jb1 R '' <br /> rg& F( . 22-6-0 Zf1Wj 9ys 4��: <br /> ENVIRONMENTAL HEALTH DIVISION FILE: <br /> 0 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 13 HOUSING A13ATEMENTM SoL]D WAsTI:FACILIT'f <br /> _ OTHER CI..I:ANUP SITE(NON-LOP) 13 FOOD FACM TY 0 �''SOLID WASTIi VEHICLE: <br /> Cr UNDERGROUND TANK(MONrrORINGIREMOVAL) 0 DOC KERNEL. i f C ammf <br /> ' V HAZARDOUS WASTE GENERATOR 13 CHICKEN RANCH ❑ pjc3 T RF.ATAIENT PLA rr <br /> W(TIERED PERMITTED FACILITY M AiIOT=_LIHOTEL .k in P1JMPi ER 77?UCKIYARD)CHE M TOILET$ <br /> ❑ TATTOOIBODY PEIRCING 0 PO0'JSPA sf t ❑ LAND'JSE ArPUCATIOM Sr= <br /> A MEDICAL WASTE:FACIL n y . ❑ PUBT3C WATER SYSTEM 0 CTHEI i(PLEASE:SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above. Select the type(s)of filtas from the list above by checking <br /> the appropriate box(es). At least one file tirpe MUST be selected. Fax t0_C,7 9 4_6A-(1138 rir� mail to the <br /> address indicated above. <br /> 2. EHD will notify the applicant if any EHD filos exist. IAn appointment i'ar mview will.be confirmed <br /> ' approximately five business days but no later than ten(10)days after I.00O.ipt of application_ The fifes <br /> will be held for a maximum of five business days for review. Appoiritmenta should be Scheduled <br /> accordingly. <br /> 3. A file that Is actively being worked aril by EHD staff may riot be immedlately available for review. A new <br /> application may be submitted when the file-js available_ ;I <br /> 4. Any file not returned in the same condition as released will be r'eorglenized by I=)iD staff at the expense <br /> of the applicant. Future rile reviews by the same applicant may�regta m a.1 B9.40 Cieposit prior to revlew. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6, Applications received after 3:00 pm will be processed the next 6usirie:s da y. <br /> �i <br /> i� <br /> CONFIRMED APPOINTMENT DATE � ��TIME.!—_�._�-----� � <br /> 1 <br /> DATE~CONFIRMED _ PHONE `FAX.` iNl['1AL5 <br /> I <br /> RF-VIEWED— YES _ NO REVIEW DATE -_---- --- -- <br /> .j <br />