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05/'07/2003 06:50 FAX 209 9480621 <br />151111EUM <br />LOG HLiiii <br />�TE RECUVED SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />304 EAST WEBER AVENUE THIRD FLOOR I . <br />MAY 0 7 2003 sr (209) 46H 34z0Zo2 <br />PUBLIC RECORDS RELEASE APPLICATION <br />. .. <br />APPLICANT _ S/AGENCY S BUSUES�l-1' i lf- G'��� •-n r- <br />- <br />ADDRESS r- Sr <br />r lyl�l _rte 9 S 7 G <br />FACSIMILE 2 <br />PHONE 2.� �4 N�" 13Kr - <br />TENTATIVE` APPOINTMENT DATE TIME <br />(Please glee 7 to 10 "InOss "ys from data of apPSptlon sub 'tta) <br />CHECK BOX TO EXPEDITE REQUEST- .00 -REQUEST P SIA IN 3 BUSINESS DAYS UX <br />_ DAT= <br />SIGNATURE OF APPLICANT <br />PROGRCM L"LEW'cMS SEARCH <br />ENVIRONMENTAL HEALTH DIVISION FILES <br />❑ HOUSING ABATEMENT In sOIIO WASTE FACILITY <br />M UNDERGROUND TANK NST/ CLEANUP srrE (LOP) ❑ FOOD FA'aLITY EI SOIJ13 WAS TE VEHICLE <br />q& OTHER CLEANUP SITE (NON -LOP) ❑ FOO KENNEL 69 DA'RY <br />t , UuN�D•�E�OR�G1ROUNDTANK (M0NrrORING(REMOVAL) ❑ CHICKEN RANCH a PKi3 TZFATMEIR PLANT <br />NA7ARDOUS WASTE GENERATOR ❑ MO'IEIhIOTEL ❑ PUMP eRTT'.UCICl1'AROlCHE[i1 TOa.ETS <br />TIERED PERMITTED FACILITY g LAi USE AppLICATION SITES <br />O TATTOOIBODY FORCING t❑ pobl spik ii SYSYEAI ❑ OTHEI;(PLI!AsEsPECIFYAROYE) <br />13 MEDICAL WASTE FACILITY <br />Of files from th'T list above by checking <br />1, the up to tan addresses In the space above. select MUSThe be selected. Fax to :.09 464-0 38 or mail to the <br />the <br />appropriate box(es), At least one file type��—'Sm <br />address indicated above. <br />2. EHD will notify the applicant if any EHD files exist. An appointor aftent �ref eel et of. a) bllcat oo TThe files <br />approximate) five business days but no later than ten (10) days iter rF:nts sh ould li scheduled <br />will be held for a maximum of five business days for review. App <br />accordingly. <br />3. A file that IS actively being worked on by EHD staff may not be Immediately avLllable for review. A new <br />application may be submitted when the file Is avallable. t.theexpense <br />4 Any <br />f thele not returned In the same condition as applicant. Future file reviews y the Same applicant may require a 587,00 deposwill be reorganized by �.HD it prior t Xreview. <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 />CONFIRMED APPOINTMENT DATE <br />DATE CONFIRMED <br />TIME. <br />PHONE FAX INITIALS <br />vcc wii , a r M"=W nnrc nICICCP.I In ap f Lw e <br />o rj, () 3m � /hes,5' i• , f 0 WlA rin a ''iE d S qq /lj - <br />��1003: rjariMn IF w�11 LT"IQ�yS• io` 594 )i <br />