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yl t K IVtIJ S <br />SAN JOAQUIN COUNTY <br />` ENNMENTAL HEALTH DEPAR NT <br />OEG 0 :1 700 30 Weber Ave 3`d Floor Stockton, CA 9.1 <br />� A 468-3420 Fax: (209) 464-0138 Web: www.co.san-joaquin.ca.us/ehd <br />HEiiLl-ii <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: �� SfY r.'f_ 7fmjs /y BUSINESS/AGENCY: E,06fb /r(J(6, <br />ADDRESS: A)r-7,?*,'Y 13WO. 511/7F 3, e,011 95 376' <br />PHONE: .209 - '�3 5- 0610 FACSIMILE: .2U? - '� 35 - OK 9 ,� <br />TENTATIVE* APPOINTMENT DATE: 451P 11-&f56 Time: <br />(Please allow 10 business days from date of application submittal) <br />CHECK BOX TO EXPEDITE REQUEST - $93.00 FEE - REQUEST PROCESSED IN 3 BUSINESS D E COPY <br />SIGNATURE OF APPLICANTDATE <br />Department Use Only <br />UNIT <br />Unit 1 <br />Unit 2 <br />Al J <br />FILE ADDRESS <br />1. <br />Street <br />&o <br />- S 7 <br />)e6&v_:-- :2 O <br />City akie, <br />2. <br />Street <br />-6001-C <br />:57AIX <br />1?00-re 126 <br />Ci <br />3. <br />Slr el <br />A0 LES <br />ZZ <br />i <br />City 1A 71VO <br />4. <br />& <br />SS <br />VA0 <br />I< *-,CitY'% <br />%�a � • � 'v <br />5. <br />Street <br />qW <br />/VLA <br />city <br />6. <br />Street <br />a <br />/ r <br />city <br />7. <br />Street <br />city <br />8. <br />Street <br />' <br />/! W A Y <br />Cit <br />9. <br />Street <br />city <br />10. <br />Street <br />city <br />UNIT <br />Unit 1 <br />Unit 2 <br />Al J <br />Unit 3 <br />t <br />CON Unit 4 <br />Unit 5 <br />"_�j W 5 N -}e, rY OCA s • .� <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES �-D+/ >, r <br />rONDERGROUND TANK US CLEANUP SITE (LOP) -�HOUSING ABATEMENT OLID WASTE FA I <br />THER CLEANUP SITE (NON -LOP) � OOD FACILITY �S LID WASTE VEHICLE ` <br />,0'UNDERGROUND TANK (MONITORING/REMOVAL) �OG KENNEL -OLID <br />eZ-HAZARDOUS WASTE GENERATOR ,,� HICKEN RANCH PKG TREATMENT PLANT <br />TIERED PERMITTED FACILITY Z MOTEL/HOTEL , UMPER TRUCK/YARD/CHEM TOILETS <br />❑ ATTOO/BODY PIERCING �OOL/SPA LAND USE APPLICATION SITES <br />MEDICAL WASTE FACILITY ;C'OTHER (PLEASE SPECIFY) .G 1L55 <br />1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checkin� <br />the appropriate box(es). At least one file type MUST be selected. Fax to (209),k64-0138 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 (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 $93.00 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. E X t <br />CONFIRMED APPOINTMENT DATE TIME <br />DATE CONFIRMED PHONE FAX <br />REVIEWED YES NO <br />6/8/2003 <br />REVIEW DATE <br />INITIALS <br />