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a <br /> 09/19/2002 16:03 20f% a 79-2225 MODESTO ATC, PAGE P <br /> I <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES ................... IL <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WE9 AVENUE,THIRD FLOOR e <br /> STOCKTON CA 05202 �100 (209)460-3420 <br /> _ <br /> PUBLIC RECORDS RELEASE APPLICATION qEP 19 2002 <br /> APPLICANT��4 BUSINCSSIAGENCY 147c e4S56c/AL2n\/jR0NMENT HEALTH <br /> ADDRESS ///7 4OA16 AA' -LMn/Y'V6 SLI)"T': LBO AAo oES'Tof CA �}rj ��j A1T�� <br /> PHONE 1 FACSIMILE <br /> --CZ69�, 579~ OP-z5 <br /> TENTATIVE'APPOINTMENT DATE_ �O/�IQ Ti TIME _. AD: CIO 40K. <br /> (PlCaac eivC 7 l0 10 6ua'�i�fro ate of aypl' a11on aWinilWl) <br /> CHECK BOX TO,EXPEDRE REQUCS7- � RC UE RO OIU51NCS5 DAYS <br /> SIGNATURE OF APPLICANT 6. DATE <br /> FILE ADDRESS THIS SIDE CMD STAFF USE ONLY <br /> PROGRAM CLEMENTS SEARCH <br /> L <br /> ti U - <br /> T L A!Cr.At AVA frAe <br /> MI <br /> Lop <br /> 0 <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDCRGROUND TANK(UST)CLEANUP SITE(LOP) O HOUSING ABATEMENT 0 SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) O FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITOWNGIREMOVAL) ❑ DOG KENNEL O DAIRY <br /> hAZAR000S WASTE GENC•RATOR 0 CHICKEN RANCH 0 PKG TRFATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOYELIHOTEL ❑ PUMPER TRVCIVYARD/CHEM'fOIL 5 <br /> ❑ TATT001BODY PBIRCING 0 POOUSPA ❑ LAND USE APPLICATION SITES <br /> O MEOICAL WASTI'FACILITY O PUBLIC WATER SYS.TCM ❑ OTHER(PLCASE 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 /> tlic appropriate box(es). At least one file type MUST be selected. Fax to 1209LG4 0138 or mail to the <br /> address indicated above. <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 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 axponse <br /> of the applicant. Futurc file reviews by the same applicant may require a $07.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received atter 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 /> .......,.. ..s. ._...- <br />