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LIW WV I.VLib�l. <br /> �� SAN JOAOIN COUNTYPUBLIC HEALTH SE CES <br /> U 11 tL <br /> L)4t/ <br /> j{� ) ENVIRONMENTAL HEALTH DIVISION <br /> U 304 EAST WEBER AVENUE,THIRD FLOOR <br /> JUL - 6 ZOO1 STOCKTON CA 95202 <br /> a I (209) 468-3420 <br /> "`-(`` PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT C�`�P ` 0` `A) r"` 1 Lod ; <br /> I j 0 A ' \/(rOn <br /> ADDRESS G_ rl0 Wr To,n Lq,e od I C / fG 15-21) O / <br /> PHONE 20 9 -3 6 -3 761 FACSIMILE <br /> 7 ^7 o <br /> TENTATIVE"APPOINTMENT DATE <br /> -7- f / — 200 ) TIME � � A-M <br /> (Please Oive7 l0 10 business days from dale of application submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-5 F- —RE- UE70PROCESSED IN J BUSINESS DAYS —7 / <br /> SIGNATURE OF APPLICANT x / DATE / ' 6�� <br /> FILE ADDRESSTHIS SIDE EHD STAFF USE ONLY <br /> Rn 1�f1 co () S 330 PROGRAM ELEMENTS SEARCH <br /> 172-00 5. 1}arla Ra 5a Togrvti (aS�u "� <br /> 0 S, dr\ Car . A'e.j'C n awe <br /> '/ (� Si koV n L <br /> OD re, •1 ar eW 41 p <br /> Ur <br /> TAT <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> OTHER <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> CLEANUP•SITE(NON•LOP) C3FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> NDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL C3DAIRY <br /> ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> AZARDOUS WASTE GENERATOR ❑ MOTELIHOTEL ❑ PUMPER TRUCKIYARDICHEM TOILETS <br /> TIERED PERMITTED FACILITY ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ TATTOOIBODY P81RCING <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <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 /> approxiinately 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 review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that,'fs 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 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 /> E <br /> ED APPOINTMENT DATE TIME <br /> IRMED PHONE FAX INITIALS <br /> YES NO REVIEW DATE <br /> EN 00 14 00107100 - <br />