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03/16/2007 09:34 20983500 2098350675 <br />DD <br />SAN JOAQUIN COUNTYPUPLIC HEALTH SERVICES <br />eNVIROIVN1EN1' , HEALTH DIVISION <br />I,&AR, 1 0 2007 304 EAST WEBER AVeNUE, THIRD FLOOR <br />�1, r I F 1 STOCKTON CA 95202 <br />Edi` I „sR�'N[v',1tFN � ;EAUK (209) 468-3429 <br />PSR; TIS' ��iCES PUBLIC RECORDS RELEASE APPLiCA7ION <br />APPLICANt Z 4S Seo fc�{►�, BUSINESSIAGENNCY oq'Lev d�92r� <br />AD D Rs S S Z!:' 't . L+�� l!►'-� a►. &\f , • y 1 /� La y�►y --CV <br />>'NOPiE b� 1 ~ 7to l� �FACSiMILE�_ gjT� .� ! 7- e <br />TENT,ATIVE'KPP-094Td„ENrDATE I -4rj-, 2 7-007 nME <br />(p;941s4 ONG 7 to id SuslAess days fro, date of appticatian su mittal)• <br />PAGE 01 <br />Z$ZZ� <br />11 CMECK SOX TO EXPEDrrE nQUIST . $78,00 FEE -, 1ST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLiCANT'=-�I4 �� ._ .. _ DATE V L <br />FILE ADDRE$S <br />�c <br />�IX <br />ENVIRONMENTAL~ HEALTH DIVISION FIL1z$ <br />IaNDS-RGROUND TA, IK !UST) CLEANUP SiTE (LOP) Q XCUSINO ABATEMENT C SOLID WAST -E FACtl <br />-'^DC7 OTMF-R CLEANUP -srm (NON.I,0F) is FOOD FACI6ITY 0 SOLID wASTE VF�1t E <br />0 UNDERGROUND TANK (MUNft0MNO/REMOVAS,) C7 DOG KENNEL O DA(RY <br />❑ ti4ZARDOUS WASTE GENERATOR r- CHICI` EN RANCH 0 P K 0 TRVATMEN'r PLANT <br />❑ '1715P90 PN_i1.11PI MD FAG1LrrY C1 A[JTEVHOTEL G] PUMPER TRI 0KrYM.=HEN TOILETS <br />❑ TATOO/80PY P51Fr.1.4 r ❑ POC"PA ❑ LAND USE APPL.1GATtoN SrraS <br />❑ MEOICa,L WASTE FACiLITY ❑ PUS1JC WATER SYSTEM O OTHER (PLEASE SPi-CIFY ABOVE) <br />1. List up to ten adGfnssat in the space above. Select the typ-s(s) Of files from the list above by checking <br />the appropriate boX(es). At least one tilt, typo MUST bo Selected. pax to 203 464- zil to tFle <br />address indip-ated aboy <br />Z EHO will notify the applicant if any EHD fifes exist An appointment for reviewwili be confirmed <br />approxi;r,attly five business days but no later than ten (10) days after receipt of application, The tiles <br />w(il bo hvid for a maxirnurrl of flue business days for review. Appointments should be scheduied <br />accordingly. <br />3- A filo that Iz actively baing worked on by END staff may not be Immodiateiy available far review. Anew <br />application may be submitted when the fil• Is available. <br />4. Any file not returned in the acme condition as released will bQ reorganized by EHD wtaff at the expense <br />Of the apptkdnt. FUtur9 file reviews by the StMe applicant may require a $78.00 deposit prior to review. <br />.5, `TENTATIVE appointment dates must ba 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 <br />REVIEWED YES NO <br />PHONE FAX <br />REVIEW DATE <br />INITIALS <br />TOTAL P.02 <br />