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FROM Geo-Phase Environmen Inc. FAX NO. : 209SG90295 Sun. 27 2000 03 03PM P1 <br /> E/WLOGMUSEN ... <br /> _. ......�_.. � 1 <br /> SAN JOAQUIN GOUNTYPUBLIC HEALTH SERVICES /p� <br /> ENVIRONMENTAL HEALTH DIVISION e U ( � <br /> 304 EAST WEBER AVENUE,THIRD FLOOR ✓(/ /� <br /> STOCKTON CA 95202 <br /> (209)4583420 N 2 7 <br /> PUBLIC RECORDS RELEASE APPLICATIONEN� ?Op <br /> .�It �t-A.-Ko.J 6usINESsIAGENCY...�T 'nA^'•Ei�1Vxt�E�1'tW. ��i�E�. . . <br /> APPLLCAN7 y/1'f5, <br /> ADDRESS j 37 tIjNE_ry_4A-J AVi5 FD Cey'ro L <br /> PHONE "- ? 5t,-t "n-5 3 FACSIMILE ?-0`120'5 o"!_q 5 <br /> ,^ <br /> TENTATIVE'APPOINTMENT DATE <br /> TIME <br /> (Please give 71010 business <br /> days from data of appl:callon su6mlLlal) <br /> 50 CHECK 63X TO EXPEDITE REOUEST-$7$.00 FEE-REQUEST PROCESSED IN 7 9U5INESS DAYS <br /> DATE <br /> SIGNATURE OF APPLICANT <br /> c �- --�-- <br /> FILE ADDRESS <br /> P� Ye S <br /> 2 3$ 1 23( <br /> 305 n u tr a <br /> -rs WcaT 1/AI.rIGC p-:c+hA y LU /t-1,+- a.o OfS gI.00 <br /> 210 05 MA ArarHr/I� <br /> VE 'YllJl4^ S9 2 <br /> 40 Wd.VE Id L7, 16-V Ts17N <br /> i <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> ❑ SOLID WASTE FACILITY - <br /> ® UNDERGROUND TANK(UST)CLEANUP SITE(LOP) O HOUSING ABATEMENT 0 SOLID WASTE VEHICLE <br /> t3 OTHER CLEANUP SITE(NON-LOP) O FOOD FACILITY ❑ DAIRY <br /> * UNDERGROUND TANK(MONITORINGlREMOVAL) Q DOG KENNEL 0 PKG TREATMENT PLANT <br /> O CHICKEN RANCH D pUMPERTRUCK(YARDICHEM TOILETS <br /> HAZARDOUS WASTE GENERATOR <br /> 0 TIERED PERMITTED FACILITY ❑ MOTEUHOTEL ❑ tJkND USE APPLICAY{ON SITES <br /> TATTOOIBODY PEIRCING ❑ POOU <br /> C C3OT14ER(PLEA5E SPECIFY ABOVE) <br /> D MEDICAL WASTE FACILITY ❑ PuBUCW WATER SYSTEM <br /> 1, List up to ten addresses in the space above. Select the types)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to f209) 4C+_4-0138 or mail to the <br /> address indlrated above. <br /> 2. EHD will notify the applicant if any) }{D 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 expense <br /> of the applicant. Future file reviews by the same applicant may require a$78.00 deposit prior to review. <br /> S. 'TENTATIVE appointment dates must be confirmed with END staff. <br /> s. 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 /> EN o0 14 ULVICD <br />