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IC 25 04 03:49p - <br />10/25/2004 16:09 4( ._..8 P. 1 <br />FNJIROFL�NiAI STH PAGE 01 <br />I it <br />DAMREC9YED__' - EHD ER <br />OCT 2 5 2004 ESAN JOAQUIN COUNTY <br />ENVIRONMENTAL IIEALTn DEPARTMENT <br />ENViR0-!,,Nlia\i f HEAL 304 E Webct Ave 3 Floor Stockton CA 95205 t jV T <br />°ERh�IT;'SERVICES� ) 468-3420 Fax: (209) 464-0138 Web: www.co.sanjoaquin.�ghd ' U <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLIGWT: D41011 L-71101-„C.X.� M/SWESSIAGENCY: J6 -V -7U F / <br />AnnaFcs• 1 - Tx�.,,�.q Gf (J� �,i� (w �e .. ,..e LIA q KYU L/ <br />PHONE: <br />TENTATIVE• APPOINTMENT DATE: �^-� 1O Tim.: <br />..p.�C' (Please www 10 bvstewss days ftm date of aPpicatlm sobn4VA <br />/-+- CHECK BOX TO EXPEDITE REQUEST - $93.00 FEE - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />/SIGNATURE OF APPLICANTti-'� ` �'�-^-�"'` DATE <br />''fl'FD rlb-- - <br />- <br />FILE ADDRESS <br />Reftis <br />z <br />Cer <br />i. <br />a Nee <br />r ane <br />Oft <br />e. Niel <br />in aeaOft <br />Y 4b �� <br />Deoarhnenl Use Only <br />UNIT �( <br />0 unit t O <br />Ue Unit 2 p\2q <br />1 <br />Unit 4 <br />❑ und5 <br />a <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES- <br />t <br />D[RGROUND TAM( (VST) CLFJWUP SITE M1O% O HOUSING ABATEMENTSOLID WASTE FACILITY <br />HER ClEAM1P SITE tNON{AP) 0 FOOD FACSILY 0 SOLD WASTE VEMCIE <br />PLANT <br />DERO DOG KENNEL 2 DAIRY <br />IMODU5 WASYE GENERATOR O CHICKEN RANC14 -0PKGTREARUCKITMENT ARDIC <br />RED PERIA(TTm FACILITY 0 MOTELIHOTEL ❑PUMPER TRVCK/YARO7CHEM TOKET3 <br />0 TATTOOBODY PIERCM/G 0 POOUSPA � LAND USE APPLICATION SITES <br />0 MEDICAL WASTE FACR.frY 0 OTHER (PLEASE SPECIFY) <br />7. List up to ten addresses In the space above. Select thetype(s) of files from the list aboye by checking <br />the appropriate box(es). At least one file type MUST be selected. Fax to (2091464-0138 or mail to the <br />address indicated above. <br />2- EHO will notify the applicant N any END files exist. An appointment for review will be confirmed <br />approximately five business days but no later than ton (10) days after receipt of application. The files <br />WIN be held for a maximum of five business days for review. Appointments should be scheduled <br />accordingly. <br />3_ A file that Is actively being worked on by EHO 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 OXpertse <br />of the applicant, Future file reviews by the sane applicant may require a $93.00 deposit prior to review. <br />S. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br />6. Appi cations received after 3:00 pm will be processed the next business day. <br />CONMIRMEDt1Ar.W DATETIME .. <br />^ Y =' r'> <br />� <br />PATE CONFIfifA>rD - 41ONE FAX <br />11IMEWED .,� 'YES NO - REVIEW DATE_--.`...:,.:. <br />EMDMi]�ii - ' <br />UMa0., <br />Y 4b �� <br />Deoarhnenl Use Only <br />UNIT �( <br />0 unit t O <br />Ue Unit 2 p\2q <br />1 <br />Unit 4 <br />❑ und5 <br />a <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES- <br />t <br />D[RGROUND TAM( (VST) CLFJWUP SITE M1O% O HOUSING ABATEMENTSOLID WASTE FACILITY <br />HER ClEAM1P SITE tNON{AP) 0 FOOD FACSILY 0 SOLD WASTE VEMCIE <br />PLANT <br />DERO DOG KENNEL 2 DAIRY <br />IMODU5 WASYE GENERATOR O CHICKEN RANC14 -0PKGTREARUCKITMENT ARDIC <br />RED PERIA(TTm FACILITY 0 MOTELIHOTEL ❑PUMPER TRVCK/YARO7CHEM TOKET3 <br />0 TATTOOBODY PIERCM/G 0 POOUSPA � LAND USE APPLICATION SITES <br />0 MEDICAL WASTE FACR.frY 0 OTHER (PLEASE SPECIFY) <br />7. List up to ten addresses In the space above. Select thetype(s) of files from the list aboye by checking <br />the appropriate box(es). At least one file type MUST be selected. Fax to (2091464-0138 or mail to the <br />address indicated above. <br />2- EHO will notify the applicant N any END files exist. An appointment for review will be confirmed <br />approximately five business days but no later than ton (10) days after receipt of application. The files <br />WIN be held for a maximum of five business days for review. Appointments should be scheduled <br />accordingly. <br />3_ A file that Is actively being worked on by EHO 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 OXpertse <br />of the applicant, Future file reviews by the sane applicant may require a $93.00 deposit prior to review. <br />S. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br />6. Appi cations received after 3:00 pm will be processed the next business day. <br />CONMIRMEDt1Ar.W DATETIME .. <br />^ Y =' r'> <br />� <br />PATE CONFIfifA>rD - 41ONE FAX <br />11IMEWED .,� 'YES NO - REVIEW DATE_--.`...:,.:. <br />EMDMi]�ii - ' <br />UMa0., <br />