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UA7E RECEIV EHD LUG NUMBER <br /> SAN JC,,.,1UIN COUNTYPUBLIC HEALTH VICES <br /> ENVIRONMENTAL HEALTH DIVISIO <br /> n� 304 EAST WEBER AVENUE,THIRD FLOOR <br /> ( l U STOCKTON CA 95202 <br /> (209) 468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT0 ` BUSINESS/AGENCY VV lL�JLn <br /> ADDRESS 123 O1OMfYl1L1�L?� l ,11-Cu '—1.yn VV1Pr� ,0 A 95181 <br /> PHONE-I I� 1 � `V - 22C)P FACSIMILE 9 tU-) �q - 2222 <br /> TENTATIVE'APPOINTMENT DATEJ=1— Z)cam. I L— TIME q .(-)(:) A.M <br /> • (Please give 7 to 10 business days frorrf date of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$78.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> IGNATURE OF APPLICANT0Q� DATE ��LD-C)d <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> u N Abe► a �-7 ao <br /> z a Et-M Ln b t 357-2-1 2F60 a U 1 23W 2 F '2309 <br /> 3l ELM L.vb.t <br /> i E LM LoD 1 1 r� I'•i <br /> i0-1 suAcoi- L.D 1--,.X 3 s ► SZ 35� 31 <br /> -2-CI LP,Ar'�-I[-I'3 E -rRA c-\e -)Dye's <br /> IO w . (aRAt&TW0G <br /> Rh t3 T L4 0G_ —k CN( ��. � � PyU'L. <br /> 24Z i i b l_L_Y <br /> 303 <br /> L01 ELM Lpt� f�0 PYesS� <br /> Rh l T -3 ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLE NUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTEL/HOTEL ❑ PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑ TATTOO/BODY PEIRCING ❑ POOLJSPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE 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) 464-0138 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 (14) 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 expense <br /> of the applicant. Future file reviews by the same applicant may require a $78.00 deposit prior to review. <br /> 5. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME L <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED 1\YES NO REVIEW DATE _ <br /> EH 00 14 02/24/00 - <br />