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n,,'07/2003 06:50 FAX 208 9480621 11002:002 <br />DATE NECOM _ emu a -OG pfumaj A - <br />�,-' '�+, SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br />ENVIRONMENTAL, HEALTH DIVISION <br />304 EAST WEBER AVENUE, THIRD FLOOR <br />M AY 0 7 - ZO03 STOCKrON CA 95202 <br />(209) 468-3420 107 <br />PUBLIC RECORDS RELEASE APPLICATI{0N <br />APPUCANT lav t.,.I S S BUS1NESSIAGENCY 11 r�nA L,� <br />ADDRESS 2 &?, r . .S'gn � <br />PHONE 1 $ 41IS l3`{ FAGSIMIL.E 2- -L L- <br />-TENTATIVE' APPowmeNT DATE J� d TIMF- <br />(Please give 7 to 10 OWness days from date of application SubmiUai) <br />CHECK BOX TO EXPF-DrrE REQUEST - $V.S -REQUEST V510ESSED IN 3 BUSINESS DAYS <br />�I <br />SIGNATURE OF APPLICANT <br />DAT » iS 3 . I <br />FILE ADDRESS <br />THIS SIDE El -1D SI AFV U, -'E ONLY <br />PROGRAM 1-LERIEHTS SEARCH <br />6 I z CAILAJUh I u - <br />STU ewe. -TJA,- <br />Mo <br />l `zr -a -f-, � s <br />N �i <br />X33 - - t <br />H <br />4 <br />_ <br />_� _ <br />a p W •{trcM a r.a' S <br />u <br />O c <br />L"" -y'3 <br />12 55 <br />. ENVIRONMENTAL. HIZALTH DIVISION FILES <br />M UNDERGROUND TANK (UST) CLEA1IUP SITE (LOP) 0 HOusiNG ABATEMENT 'I soiao WASTE FACtt TTY <br />IX OTHER CLEANUP SPIE (NON -LOP) ❑ FOOD FACUTY IN $01.10 WAO rE VEHICLE <br />UNDERGROUND TANK (MOMMORINGIREMovAL) o 000 KENNEL 63 Damr <br />HAZARDOUS WASTE GENERATOR 13 CHICKEN RANCH Car Pw-, TAEA1 M611T PLANT <br />TIERED PERMFITED FACILITY O MOTWHOTEL C7 PUMP=RTFUO YARDICHOITCH-ET5 <br />n TATTOOIBODYPEIRCING a •POOUsPA _ , UU40 USEAPPLICATIONSrTES <br />0 MEDICAL WASTE FACILRY pL PUSUC vfAT1R sysi'EM - 13 O'n1E11(PU!A5C sPI+C1FYAISOYE) <br />1. List up to ten addresses In the space above. Select the typ(s) of tiles ftom th-i list above by checking <br />the appropriate box(es). At least one file type MUST be selected.' Faxtil'09� 464-0J 38 o r .ail to the. <br />address Indicated above. <br />2. EHD will notify the applicant if any EHD flies exist_ An appointment for reiriew will bo Confirmed• <br />approximately five business days but no later than ten (10) days after re -elpt of application. The files <br />will be held for a maximum of five business days for review. Appolntmcnls should be scheduled <br />accordingly. <br />3. A file that Is actively being worked on by EHD staff may not be Immedialely avallable for review. A nim <br />application may be submitted when the file is avallAble. <br />4. Any file not returned in the same condition as released will be reorganl::e<I *by 1.113 staff at.the expense <br />of the applicant. Future file reviews by the same applicant may requlre a :f87X0 deposit prior to review. <br />S. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br />6. Applications received after 3:00 pm will be processed the next busines:l day. <br />CONFIRMED AppommiNT pA' a TIME, <br />DATE CONFIRMED PHONE FAX INMIALS <br />0C%nCU=n vire wan d/� oe�rrmu nAT r <br />