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FROM Geo-Phase Environmental Inc. FAX NO. : 2095690295 Dec. 24 2002 12:03PM P2 <br /> --�+ r <br /> i <br /> �1-11�t ( ii� , �� <br /> ALTH SERVICES[SAN JOAQUIN COUNTYPUBLIC HE '�``7 „✓ <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR I <br /> DE_C 2 4 2002 STOCKTON CA 05202 <br /> (200) 468-3420 <br /> FINV I)'Ok.iiw,i'1i . tr''��iPUBLIC RECORDS RELEASE APPLICATION <br /> r•�+r r r r,F it <br /> S � <br /> APPLICANT �'Y T/� 8U51NESS/AGENCY �,L"��k>�,Sc' /��!,�.,�•�r,� <br /> ADDRESS 9937 1/eeMe--»r t?-t <br /> PHONE D,Z�� FAGSIMILE �` <br /> TENTATIVE"APPOINTMENT DATE / 3/ /0.11 TIME <br /> (Please give 7 to 10 busincs days from daic of application submittal) ' ' <br /> 4M CHECK BOX TO,EXPEDITE RCQUE5T-$87.00 FEE—RCOUEST PROCESSED IN 3 BUSINE55 DAYS <br /> SIGNATURE OF APPLICANT –. � BATE l/ S' � Z <br /> —y <br /> r FILE ADDRESS THIS SIDE EHD STAFF Us QALY <br /> I PROGRAM CLEME•NTS <br /> � '7 s, $ ba '• �I r e C/Corin <br /> f <br /> 912. oe- 4ele6er sr¢ S G ""70, A01 <br /> 5d G <br /> (� et- <br /> An <br /> t <br /> EE] <br /> s <br /> z <br /> ENVIRONMENTAL.HEALTH DIVISION FILES <br /> ZNDCRGROUND TANK(U-5T)CLEANUP SITE(LOP) 0 HOU5ING A13ATEML'NT 0 SOLID WASTt:FACILITY <br /> . OTHER CLEANUP SITE(NON-LOP) O FOOD FACILITY 0 SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) 0 DOG KENNEL D DAIRY <br /> 0 HAZARDOUS WAST-5 GENERATOR 0 CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> u TIERED PERMITTl t FACILITY O MOTEL]HOTEL O PUMPER TRUCKIYARDICHEM TOILETS <br /> 0 TATTOOIBODY PIJIRCING ❑ POOLISPA 0 LAND USE APPLICATION SITES <br /> L MEDICAL WASTE FACILITY 0 PUBLIC WATER SYSTEM 0 OTHCK(PLCASC SPECIFY AClOVC) <br /> 1. 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. Fax to (209) 464-0138 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 revicw. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that Is actively boing 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$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 /> I • <br /> ! ' CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> I •J• <br /> REVIEWED ; YES NO REVIEW nATF <br />