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�0c,t :28 . ;2003 . 539P Nei- Andersor, & Assoc No , 3395,, ,P . 2 <br /> SAN JC- AN COUNITPUBLIC HEALTH SERI, S <br /> 0 i;T 2 8 2003 ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> '' `- FS <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT V`6 UUGINESS/AGENCY <br /> ADDRESS o S o. Ct. Loc <br /> PHONE 2-0') FACSIMILE LjZZ 8 <br /> TENTATIVE*APPOIN�Pl-aas& <br /> ENT DATE/�I' �I / �/ JLME (� <br /> sive 7 to 10 bumin.da from data of application whmittal) <br /> CHECK BOX TO EXPEDITE RE UEST• .0 RE E T PRDCESSID IN 3 BUSINESS DAYS <br /> SIGNATURE OF AP LiCANT DATE <br /> . � lJ <br /> FILE ADDRESS �) � c\ Q S THIS SIDE EMD STAFF US?-ONLY <br /> I PROGRAM ELEMENTS SEARCH <br /> S 3 <br /> t S <br /> W. se V ,- <br /> / ENVIRONMENTAL HEALTH DNISiON FILE6 <br /> ,M ERGROUND TANK(UST)Cl El SITE(LOP) HOUSiNG ABATEMENT ❑ SOUD WASTE FACILITY <br /> HER CLEANUP GrM(NOK-LO ) 0 FOOD FACi M ❑ SOLID WASTE VEHICLE <br /> HDEROROUND TANK(M0WTO iNOlREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> AZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> T15RED PERMrTTED FACiUTY O MOTEUHOTEL ❑ PUMPER TRUCKNARDICHEM T01LPT3 <br /> 0 TATTOCII300Y PEIRCING C1 POOL/SPA ❑ LAND USE APPLICATION SiTEs <br /> MEDICAL WASTE FACILITY C1 PUBUC WATER SYSTEM 0 OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to tin addre ses in the space above. Select the type(s) of files from the list above by checking <br /> the approp�ate box es). At least one file typo MUST be eoloctod, Fax to_(2091 464-0138 or mall to the <br /> ve. <br /> 2. END will notify the i pplicant If any EHD files exist An appointment for review will be confirmed <br /> approxima )y five usin ass days but no Inter 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 /> according , <br /> 3. A file that hi active) being worked on by EHD staff may not be immediately available for review. A new <br /> application may be submitted when the filo 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. Fu ure file reviews by the came applicant may require a $88.00 deposit prior to review. <br /> 5. 'TENTATIV�appoin ment dates must be conflnned with EHD staff. <br /> 6. Application received after 3:00 pm will be processed the next busimoss day. <br /> CONFIRMED APPOINTMEhrr DATE TiME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br />