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05/22/•Ql IJI'10:04 FAX 918 488 7013 KL.EINFELDER 2 002 <br /> o- SAN J IAQUI.� � EP <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> MAY 19 2 L003 STOCKTON CA 99202 <br /> -1�1 ' '\'I '! ' ' ! - -: J�! (209),168-3420 <br /> 130 <br /> PURL C RECORDS RELEASE APPLICA�I-ION <br /> APPUCANT�ChI�� A'V1 . BUSINGSSlA6ENCY <br /> ADDRESS J�77 IY --rtC1'L(.nw <br /> PHONE 1UJ Q 1 FACSIMILE I II(O (P" I01 <br /> TENTATIVE"APPOINTMEN DATE LI�� �a'Tl /,Y I%{7✓tV1'�ti�•4�1 l�- U � j� <br /> (Flesse give T W 10 business days from dale of applicAt' n.submittal) <br /> u CHECK BOX70 EXPEDITE REQU -S87.00 FEE—REQI T'ROCESSED IN 7 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT }� J ti , []AT1= <br /> FILE AUD :SS Tt11Si51DE.EIIDSS7AFT-U3EONLY <br /> PRtxMRAM I:LEM-tNTS SEARCH <br /> W75 , G in e" A <br /> 11F411111l"101 211, y _ <br /> 3 2003 ENVIRONM 1 Hr_ALTH DNIS v 1 <br /> A{UNDERGROUND TANK(UST)CLEANU SIT(LOP) ❑ HOUSING ABATEMENT <br /> THER CLEANUP 31TE(NON-LOP) ROOD FA:iL rrT <br /> UCI <br /> TANK(MONITORING! MOYAL) O DOG KEIrNEL lJ <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH <br /> 'FY TIERED PERMFFTED FACILITY ❑ MOMUHOTEL <br /> ❑ TATTactsopy PEIRCING d-POOLisr-. - <br /> ❑ MEDICAL WASTE FACILITY O PUBUC k/ATER SYSTEM <br /> 1. List up to ten addresses in the space above. .elect the type <br /> the appropriate box(es), At least one file type M1.157 be solei <br /> address indicated above, <br /> 2. END will notify the applicant if any EHD files e:rist. An appol _•- --•. -. •--- <br /> approximately Five business days but no later than ton (10) days after re,::ei pt o":application. The files <br /> will be held for a IT1341TIL m of five busine:is days for review. Appointrnerib;should bia scheduled <br /> accordingly. <br /> 3. A file that is aCUlvely heir g wariKed on by EHD Staff may not be Immediatnly av;l ilabie for revlew. A ne)v <br /> application maybe subrr Itted when the file is available. <br /> 4- Any file not retumed In tie same condition as released will be reorganiz nd by EAD staff at the vxpensi= <br /> of the applicant. Future Ile reviews by the same applicant may require it$37.00 df)posit prior to reviewv, <br /> 5. "TENTATIVE appointmen t dates must be confirmed with EHD staff. <br /> 6. Applicadans received after 3:00 pm will bis processed the next business,dry. <br /> CONFIRMED APPOINTMENT D ►TE TIME <br /> DATE CONFIRMED PH ONE FAX INITIALS <br /> REVIEWED YES NO REVIFEW DATE <br /> Er 40 u oawioo <br />