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FROM Geo Phase Envirc-rjrnan FH•;" NO. : -'09'E.90295 ILLI. -.1 <br /> 01c)LOG 411r,40 <br /> W <br /> S JOAQUIN COUNTYPUBLIC HEALTH SE cS <br /> �' JUL 3 1 ZO ENVIRONMENTAL HEALTH DIVISION <br /> 11 304 EAST WEBER AVENUE,THIRD FLOOR <br /> i -U <br /> - ? STOCKTON CA 95202 <br /> (209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT <br /> SUSINESSIAGENCY a-1--ovAr <br /> AC)DRP-$S j2:V17 12�9�f ela-0 <br /> PHONE FACSIMILE. <br /> TENTATIVE'APPOINTMENT DATE TIME 20,01, <br /> (Please give 7 to to 6usiness days-trom date of application submittal) <br /> BJ 61W17-::5 E�4)4 3 BUSINESS DAYS <br /> CHECK BOX TP EXPEDITE REQUEST, &.B9 FEE-REQUEST PROCESS 1 <br /> .4 DATE <br /> SIGNATURE O! AFPLJCANT'::�e�e <br /> FtLJ�ADDRESS <br /> team& <br /> le <br /> Z%LZ 13 n ;N rl 0 r,3 r-1% <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> ,IC-uNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 IjOUSINr,ABATEMENT 0 SOLID WASTE FACILITY <br /> 0 OTKER CLEANUP SITE(NOWLOP) 0 FOOD FACILITY 13 SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) Cl DOG KEN14EL 0 DAIRY <br /> HAZARDOUS WASTE GENERATOR 13 CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> C3 TIERED pE-RMITrVl)FACILITY 0 MOTELIHOTEL 0 PUMPER TRUCKIYARDICHEM TOILETS <br /> C] TATT04113QDYpFjR0lNG r-3 POOLJSPA 11 LAND USE APPLICATION SITES <br /> 12 MEDICALWA&IF-FACILITY 0 PUBLIC WATER SYSTEM El OTHER(PLEASE SPECIFY ABOVE) <br /> I List up to ten addresses in the space above. Select the'typq(5)of riles from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to f209)464-(1138 or mail to the <br /> address indicated above_ <br /> 2. EHD will notify the applicant if any EHD file$ 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 file* <br /> will be held for a maximum of five business days for review, Appointments should be scheduled <br /> accordingly. <br /> 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 availablu- <br /> 4. Any file not returned in the sarrI6 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 $78.00 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 VAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EH 00 14 DVIWOCI <br />