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04/30/2003 09:42 FAX 209 9480621 Q-1002 003 <br /> EHD LOG NUMBER <br /> DATEREjCFIVED, J INOEN <br /> OTYLALHo <br /> UBLTHSES0ENVIRMTAHIVISION <br /> APR 3 02003 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> j tNIJ]EAL (209)468-3420 <br /> 1-NWN WU -'ION <br /> BLIC RECORDS RELEASE APPLIGAI <br /> APPLICANT BUSINESWAGENCY <br /> ADDRESS <br /> PHONE fqk- 13 c-1-5- FACSIMILE <br /> TENTATIVE*APPOINTMENT DATE Time _ZZ '©C2 <br /> 71 <br /> . -f , <br /> (Please give T to 10 business days from date of application submittal) <br /> ,4 <br /> CHECK BOX TO EXPEDITE REQUEST-$67.00 FEE-REQUEST PROCESSED IN 3 BUSINESS Y <br /> SIGNATURE OF APPLICANT ;; I - 0 AT E <br /> FILE ADORESS THIS SID(.:EHD STAFF USE ONLY <br /> PROGRJAM r_-LjEjViENTS SEARCH <br /> Clv& <br /> QW. <br /> \j !Q" Atvi- <br /> �rc 1&s 111V4 L1 <br /> COV�4r-v Cho1 <br /> lqo 3 <br /> oveti—Y CIV6 <br /> \IJ C, <br /> /a lo-7 Com4-p-X C4 C"k jllwd <br /> X 5 7 15 <br /> ;2 70 9u., 0146 Cj2-- Cl <br /> tn� ) HIE,I L, Jp <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> _01UNDF.RGRouND TANK(UST)CLEANUP SITE(LOP) 13 HOUSING ABATEMENT 0 _qnLII)WA ;TF_FACILITY <br /> ,,gr OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY Siiuv WxTrE VEHICLE <br /> !Ja--U-NDERGROUND TANK(MONITORING/REMOVAL) 0 DOG KENNEL i7 DAIRT' <br /> a HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH C3 pKG*rREATMENT PLANT <br /> a TIF-RED PERMITTED FACILITY 0 MOTELIHOTEL 0 Pumf,ER TRUCKfYAROICHEM TOILETS <br /> 0 -rATTOOIBODY PEIRCING 0 PbOUSPA "-­ E3'U,NEI USE APPUCAT(ON SITES <br /> 0 MEDICAL WASTE FACILITY o puauc WATER SYSTEM CI o,rHI,*R(PLEA$E SPECIFY ABOVE) <br /> I List up to ten addresses in the space above. Select the type(S) of-riles frcim the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. FAX j,,0( 9 64 _38 or mail LO- —the <br /> ZU_A._-01iii <br /> address indicated above.. <br /> 2. EHD will notify the applicant if any EHD files exist An appointment for reviev,1 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. Appointrrients should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immedintoly available for review. A new <br /> application may be submitted when the rile 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 applicaht may requirt.- a$87-00 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 nextbusine.,;s day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITtA.L.-S <br /> REVIEWED YES NO REVIEW DATE <br />