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FROM NOR Environmental PHONE NO. : 209 369 4228 Dec. 23 2002 12:25PM P4 <br /> _ r�u <br /> ,SA1JIOAQUIN COUNTYPUBLIC HEALTftERVICES Sw xuwaOt <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WESER AVENUE,THIRD FLOOR I <br /> DEC 2 3 2002 STOCKTON CA 95202 <br /> (209)468-3420 <br /> "R01(PUBLIC RECORDS RELEASE'APPLICATION <br /> APPLICANT /'I1If pLj�( BUSINESSIAGENCY�I <br /> ADDRESS ZZ X1 . W.' a. qq,7qD <br /> PHONE (205 367^3701 ,FACSIMILE !* 3 g <br /> TENTATIVE"APPO►N7MENT oATs A. /P 2&.3 TWE ;�a V <br /> 03 74. <br /> (Please give 7 to 10 business days from date of application submittal) <br /> 11 CHECK 80' X TO EXPEDITE REQUEST-$89.0o FEE- RE ES UPROCESSED IN 3 BUSINESS DAYS � ' I <br /> SIGNATURE OF APPLICANT DATE Z3 . 2— <br /> FILE ADDRESS THIS S127E EHD STAFF USE ONLY <br /> PROGRAM E-LSMENTS SEARCH <br /> c 'f <br /> r. Lo 51 , <br /> Z <br /> {� OZ �• GI - � <br /> i ,.,, r <br /> kid !9*,Q �C- <br /> .AJJIt! <br /> ENVIRONMENTAL HEALTH DIVISION FILES (( r <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 13 HOUSING ABATEMENT O SOLID WASTE FACILITY <br /> O'OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY O SOLID WASTE VEHICLE <br /> 01f UNDERGROUND TANK(MONITORINGIREMOVAL) U DOG KENNEL D DAIRY <br /> e HAZARDOUS WASTE GENERATOR Q CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> 13 TIERED PERMITTED FACILITY ❑ MOTUMOTEL ❑ PUMPER TRUCYJYARD/CHEM TOILET^, <br /> 0 TATTOO/RODY PEIRCING ❑ POOIJ%PA El LAND USE APPLICATION SR7rS <br /> ❑ MEDICAL WASTE FACILITY 13 PUBLIC WATER SYSTEM �'OTHER(PLCASt SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to (209)464-013$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 reorUanized by EHD staff at the expense <br /> Of the applicant. Future file reviews by the same applicant may require a$89.00 deposit prior to review. <br /> 5. "TENTATIVE appointment dates must be confirmed with END 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 /> .n npnr <br />