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' Mar . 5. 2002 5:07PM C"MOOR EARTH TECHNOLOGIES No-8600 P. 2/4 <br /> ATE RECE1 ED EHA LOG NtlbMrR `•J <br /> I SAN J0 UIN COUNTYPUBLIC HEALTH ORVICES <br /> NVIRONMENTAL HEALTH DIVISION A <br /> ro <br /> -304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> N` '' - P i - 12111114,11-3420 FILE 0 <br /> �b]491C RECORDS RELEASE APPLICATION <br /> APPt,1CANT_ _ -' - -�.=_BUSINESWACENCY „f <br /> . , . <br /> ADDRESS <br /> PHONE FACSIMILE <br /> TENTATIVE*APPOINTMENT DATE fmc, .-nME I✓1 <br /> 141/7-5 <br /> ase Siva 7 o hu�sln days rtt date appfi flan submlttai) <br /> � <br /> L_1 PEDrIE RT Q >;E <br /> -$87.tl0 F - A QCE DeN3'BIISINESS DAYS <br /> CHECK BOX TO Fx <br /> SIGNATURE QF APPLICANT DATE <br /> BILE ADDRESS THIS S1DB END STAFF USE ONLY <br /> PROGRAM ELMAENTS SEARCH <br /> 01 <br /> Q - . <br /> q t ►� v <br /> ENVIRONMENTAL HEALTH DIVISION FILES/ � <br /> �3 NDERGROUND TANK(0"CLEANUP'SITE(LOIS) b HOUSING ABATEMENT � SOOLID WASTE FACILITY <br /> LID WASTE VEHICLE NI�'C�THER CLEANUP SITE(NON-LOP) ❑ FOOID FAC11 TY UNDTANK MONITORINGIREMOVAL) L1 DOG KENNEL DAIRY <br /> �2 J.INDER6R0 ( Ci PKG TKEATMENT PLANT <br /> �A�pRI70U:1 WA5TE GENERATOR O�CHiCKEN CZANCFI <br /> TIEiZ p�,Mr1T>D FACILITY 0 MOTELMOTEL Cl PUMPM TRUCKIYARDICHEM TOILETS <br /> C3/TATTOO/BODY PEIRCING M POOL 8PA " - El LAND USE APPLICATION SITES <br /> Cg MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM 0 OTHER(PLEASE SP:CI Y ABOVE) <br /> 11 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. !'ax io 2091 464-01-IR or mail to-!Le %_ <br /> address indicated above. <br /> 2. EHD will notify the applicant if any EHD flies 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 bo 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 EHO 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$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 next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS .T <br />