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03/19/2009 12:00 FAX 209 9480 @IOt}2'002 <br /> FJ1[i Ur-NUMBER <br /> °170' � v 7 r� SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> C {'��J if }l~?j ENVIRONMENTAL HEALTH DIVISION <br /> 304 FAST WEBER AVENUE,THIRD FLOOR <br /> MAR 19 2003 STOCKTON CA 95202 <br /> (209)468,420 <br /> ENVIRONMENT HEALTH PUBLIC RECORDS RELEASE APPLICATION[ <br /> APPLICANT w V LS+1 BUSIHE WIAGENCY \rt�il�•,F��_ -, I..1� <br /> ADDRESS <br /> PHONE 'ri0 qJ GI 14 �-I FACSINULE r - <br /> TENTATIVE*APPOINTMENT DATE 3 11'41) 03 TIME Z <br /> (Please gfve 7 to io business days from data of 8pPnea00A"MMI'ttaq - <br /> BUSINESS DAYS <br /> a <br /> CHECK BOIL TO EXPEDITE REQUEST-SOT.00 - REQUEST PROCESSED M b • <br /> CRATE <br /> SIGNATURE OF APPLICANT <br /> \ , FILE ADDRESS THIS SIDE FLEA STAFF USE ONLY <br /> � PROGRAM ELEIIIIENT:I sf:AlrcH <br /> C- fK- ti . <br /> LM-194, LA <br /> Lg., i POI A.A. <br /> 0 . 1.8,w%sE p*& 4r2M wP cA <br /> �.J . �,cL►t?� P++ "FUS+ CA, --- <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> SOLID WASTE FACIUTY <br /> UNDERGROUND YANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENTSt Saro wASTE YEFf[CLE <br /> OTHER CLEANUP SITE(NON-LOP) O FOOD FACILITY 10 <br /> UNDERGROUND TANK(MONMORINGMEMOVAL) DOG KE RANCH IF PKG TREATIVENT PLANT <br /> 0 <br /> �I HAZARDOUS WASTE GENERATOR CHICKEN <br /> RAMC ,. l.PUMPER TRUC117YARDICHEM TOILET9, <br /> IX TIERED PERMI 4 1 D FACILITY ❑ 1g LANID USE APPLIR.ATION SITES <br /> ❑ TATTOOMODY PEIRCING A'POOIJSPA - G OTHER(PLEASE SPECWY ABOVE) <br /> O MEDICAL WASTE FACILITY qL PUBLIC WATER SYSTEM <br /> 1. List up to ten addresses In the space above. Select the type($)of files from the list above by checRIng <br /> the appropriate box(es). At least one file type MUST be selected. Fax to„VgM 464-g138 pull Eat e <br /> address Indicated above. <br /> 2. EHD will notify the applicant if any EHD files exist. An appointment for review will ttie confirmed <br /> approximately five business days but no later than ten(10)days afterreceipt houlcpli application. <br /> e files <br /> will be held for a maximum of five business days for review. Appointments <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff May not be Immediately available for review- Anew <br /> applicatlon may be submitted when the file is available. anlzed b EHD staff at the expense <br /> 4. Any file not returned In the same condition as released will be reorg y <br /> of the applicant. Future tale reviews by thb same applicant may require a$8T.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 buslness day. <br /> CONFIRMED APPOINTMENT DATE _ TIME• - — <br /> DATE CONFIRMED PHONE FAX 1NrnAL:3 --------- � <br /> REVIE MD 'YES NO REVIEW DATE <br /> .Y N zz MOM <br />