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06120/2003 08:37 9163415808 SWRCB GQ BR PAGE 01/01 <br /> GATE REC0VE0 <br /> EM LOG NLM M <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 FAST WEBER AVENUE,THIRD FLOOR <br /> JUN <br /> (j' 2003 STOCKTON CA 95202 <br /> (209)468342® <br /> .,,,, PUBLIC RECORDS RELEASE APPLICA710N <br /> PLC N,�, LA APPLICANT ' � BUSINESS/AGENCY � <br /> ADDRESS <br /> PHONE ( FACSIMILin 3`"i (•_ 7t I <br /> -- by au_. <br /> TENTATIVE*APPOINTMENT DATE f25TIME <br /> (Please give 7 to 10 b meas ye from det of application a I mlttail <br /> CHECK BOX TO EXPE�DITE REO S •;89.00 FEE—REflU ;PROCESSED IN 3 BUSINESS DA1'S LkiA31 <br /> 1i <br /> SIGNATURE OF APPLICANT _ DATE: r <br /> THIS SIDE EHD STAFF USU ONLY <br /> FILE ADDRESS PROGRAM ELEMENTS SRARCH <br /> y - <br /> a -- <br /> RAN"Mm- .film <br /> -r� <br /> ENVIRONMENTAL HEALTH DIVISION FILES. <br /> ❑ UNDERGROUND TANK(UST)CLEANUP SiTE(LOP) ❑ HOUSING ABATEMENT 0 SOLID WAS'l i=_r•ACrL.fTY <br /> ❑ OTHER CLEANUP sn'E(NON-LOP) d FOOD F MUTY 0 SOLID WAS1 E-VEHIwI.E <br /> ❑ UNDERGROUND TANK(MONETORINGIREMOVAL) Q DOG KENNEL Cl DA 11.Y <br /> 4 HAZARDOUS WASTE GENERATOR ❑ CHICKE'V RANCH 0 PKC TPEATA TENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELi:4OTEL C1 PUMPER TRUCKIYARDICHEM 101LETS <br /> ❑ TATTOOIBODY PEIRCING 17 POOLIS 31A Cl LAND USE A''PLICATiON SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER 'PLEASE SPECIFY} ._�„____ �^- <br /> 1. List up to ten addresses in the space above. Select the type(s)of files f om the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. n tto-LD.91"I IN4IL' sr mail to the <br /> address Indicated above. <br /> 2. EHD will notify the applicant if any EHD filies axist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10)days after renelpt 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 lmmsdlatnly ava1able for revleve. A new <br /> application may be submitted when the file is available. <br /> 4. Any file not returned in the same condition a:l released will be reorganir�d by P HD : teff at the :xpense <br /> of the applicant. Future file reviews by the same applicant may require ei$09.00 deposit prior to review. <br /> 5. "TENTATIVE appointment dates must be Contirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRM66'APPOINTMENt I AI - <br /> ,: Pl i'dNL"- .. --I�i►IX'��" :••' • •1i�IITi1')L•�'a _:: '' _ t <br /> D'ATECONFIRIVlED • . . .'..:...... .. ;.: , .x:W�� <br /> =1 Etf1EWED Y.ES• '.NO ; 'I2EVIEV9"tlAT :. _ <br /> s,..• -. ..r.. . <br /> EEO 43-02-Q09 <br />