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02/07/2003 12:31 949-586-7315 AMES - LUIS PEREZ PACE 01 <br /> �T - J� l <br /> 9:, 0'r,2 <br /> 10.49 4 , ..,13.- EII'JIPOI 4FDIT,iL. HEALTH PAC ell <br /> W-B 0 7 2003 SAN JOAQUIN COUNTYPURLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> •"[� ..,,/,/ v 004 EAST WEBER AVENUE,THIRD FLUUR41;1I I <br /> 1 �� STOCKYON CA 95202 <br /> (209)468.3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> /APPLICANr,�.h � --y� �� .R-�—p• ���JJJ///--*)r <br /> 1 4 ......_,........_BUSINCSSIAGENCY .�I, <br /> �,�iAooaess_�_.�✓%�1io_2.._�_✓+P�-._.��+/. ///�ti , , C� __.l..s�...lc�0 <br /> IPHGNt ._/c11 ��lt:_ j5�732 ..... LyS ,,r =-2-r•--.--� _ / <br /> TF'-NYATIVC•APpOiNYMENT DATe _ TIME <br /> --'- -- ._..._......r VVV V <br /> 1pfense alva7 to t0 U'ualneaa nays Irom Jain vl aph,Ilchtivn aubmin+a) <br /> ,tom CHECK OOX TO EXPBUI7e REQUEST-359.00 FEE-..REOVEST PROCESSED IN S BUSINESS GAYS LAn , <br /> -F 3 ' <br /> SIGNATURE OF APPLICANT <br /> DATE <br /> PILL AUORESS THiv'SIDE raNO S'rAFF USC ONLY <br /> - PROGRAM RLE ENTU SEARCH <br /> C.-_ IIE�_ 1116✓11f�4 Y)S�_U <br /> l � <br /> c - <br /> �.__..._.__.......... <br /> — <br /> ------aL <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> pf uNnEROROVND TANK(VST)CLEANUP SITE(LQP) ❑ HOUSING AOATCMCNT ❑ SOLID WASTE 1'ACIUTY <br /> b OTHER CLEANUP SITE(NON4,OPI O FOOD FAGILI rY ❑ SOL 10 WASTE 1qi HILI F. <br /> i`♦0 UNDERGROUND TANK(MONITORINGIREMOVAL) 0 000 KENNEL ❑ DAIRY <br /> 4 `f Q, HAZARDOUS WA57E GCNEnATOR ❑ CIIICKCN RANCH O PKO Tnr.ATMLNr PLANT <br /> t ❑ TIERED PERMITTED FACILITY ❑ MOTEUHOTCL O PUMPER TRUCK/YARDICHEM TOILETS <br /> 1 0 TATT0010ODv PL-INCING U POOUSPA O LAND USE APPLICATION SITES <br /> \\❑ MEDICAL WASTE FACILITT Q OTIICR IPLEASF SPCCIrY AnGVF) <br /> 1• List up to ton addresses In the space above, Select the lypo(s) of filar from the list above by chocking <br /> the appropriate bux(es), At least one rile type MUST be selected. Fax to (209) W-11,1111 or mn!I In the <br /> adc(rass indicated above. <br /> 2, EHD will notify the applicant if any EHD files exist- An appointment for review will be confirmed <br /> approximately five business days but no later than ton (10)days after receipt of applloalion. Tho files <br /> will be hold for a maximum of five businoss days for review. Appointments should be Scheduled <br /> accordingly. <br /> 3. A file that is actively bL•ing worked on by LHD Staff may not br- Immedlnlely available for review. Anew <br /> application may be submillad when the file is availab(a- <br /> 4. Any filo not returned 1h the same condition as released will be reorganized by EHD staff at(Ire nxpensv <br /> of the appilcant. Futuro filo reviews by the same applicant may require a $59.00 doposit prior to review, <br /> 5. 'TENTATIVE appointment dales must be confirmed with EHD staff. <br /> G. Applications received after 0:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME I,"m <br /> _. ---.—..----�K____ mptrt.IL <br /> Co. <br /> DATE CONFIRMED PHONE FAX pry,nq �— <br /> . d.l� N b�-�N"-x"-• <br /> REVIEWED AYES _ NO EV <br /> RIEW DATE <br /> �.. _-_......rte Faa <br />