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Apr • 17 . 2003 10:38AM CON5,^,°D EARTH TECHNOLOGIES No -434 P • 1/1 <br /> ° moi?1Tz�? IISI� I-�JSAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> V APR 1 ,7 2003 .ENVIRONMENTAL HEALTH DIVISION J <br /> 304 EAST WETHER AVENUE,THIRD FLOOR <br /> ENV1HUPdMENT HEALTH STOCYTON CA 95202 I <br /> PERMIT/SERVICES • (?.09) 468-3420 I a y g <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> (.L <br /> APPUCANT�,:0. ��M'�r'.. \ '•r-SaUSWE1S3-/A`GENCY C 1 �Q' CF�i1_I��, <br /> ADDRESS J'Z?) �-Q.S-i <br /> PHONE � __. _ FAC3119LE !-�Gi• ��-� __ (J�", <br /> TENTATIVE'APPOINimI=NT DATE_� Yl �J TIME '� d L>p_i - L 311`✓ <br /> (Plea"give 7 Will business days fi v, date at application su TtlA <br /> CHECK BOX TO EXPEnrM REQUEST-S87.00 FEF-REQUEST PROCESSED IN 3 BUSINESS DAYS Lo'+ A 13, q <br /> SIGNATURE OF APPLICANT DATE <br /> Fg.I-ADDRESS --THIS E:HD STAFF'USE ONLY — O <br /> PROGRAM ELETAENTS SEARCH <br /> V Sod E, l ero Pf - — <br /> APA =0 _ <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST) CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT V� SOAJD WASTE I�ArU nY <br /> OTHER CLEANUP SITE(NOWLOP) ❑ FOOD FACILITY C SOIJD WASTE VI:FFICLE <br /> UNDERGROUND TANK(MOKIORINGIREMOVAL) ❑ DOG KENNEL ❑ DARY <br /> HA7ARDOUB WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKR TTtEATMETri PLANT <br /> AU TIERED PERMITTED FACILITY ❑ MOTEiMOTEL ❑ PUhIPt:R TRUCKIYARD/CHEII TOILF_T, <br /> ❑ TATTOOfBODYPEDWANG in P60"PA " ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACaJTY ❑ PUBLIC WATER SYSTEM ❑ OTNEF� (PLEA-SIF SPECIFY AROYL <br /> 1. List Up to ten addresses in the space above. Select the types) of files fronT the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. to 179 484 09 S or m;�il ?o the; <br /> address indicated above. <br /> 2. EHD will notify the applicant H any EHD files exist. An appointment for r view will tie confirmed <br /> approximately five business days but no later than ten (10) days after receipt of application• The Iles <br /> will be held for a maximum of five business days for review. Appointment;;should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be lmmedlati ly avaliakde for review. A n w <br /> application may be submitted when the fit* 1.5 available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expon-ter <br /> of the applicant. Future file reviews by the same applicant may require a SE17,00 dcfmsit prior to ravi(-'vr. <br /> 5. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the ne)d business day. <br /> CONFIRMED APPOINTMENT DATE TiME <br />