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FROM Geo -Phase Environmental Inc. FAX NO. : 2095690295 JJ 02 MU3 09:11AM P2 <br />SAN JOAQUIN COUNTYPUBLIC 14EALTH SERVICI.-S <br />ENVIRONMENTAL HEALTH DIVISION I <br />304 EAST WEBER AVENUE, THIRD FLOOR I <br />JUN n 2 Zo03 STOCKTON CA 95202 <br />(209)458-3420 <br />tjn . QNMER UL LjH PUBLIC RECORDS RELEASE APPLICATION _ Y_ <br />PERPAIT/ ERVICES / �1 Cli- <br />APPLICANT 'ar e- AQ'� I1J�7'' DwUSIINESS/Ar-ENCY ��L1 �'G03� �'e'1r•';,:,,�,__, <br />PHONES y 'd.r2 �� - FACSIMILE <br />TENTATIVE' APPOINYMENTDATL'/4y C,�� TIME <br />(Plnse Diva Y to 10 from date day:, frodate of application subminal) <br />pp�� r. <br />VL -CHECK BOX TO,EXPEDITE REQUEST - $07.00 FEE - RCQUEST PROCESSED IN 3 BUSINESS OATS <br />SIGNATURE OF APPLICANT <br />I FILE ADDRESS <br />i <br />THIS SIDE EHD ST%FF USL ONLY <br />PROGRAM t:LEMIENTS SItAH �h <br />r SC • J. T Tyr <br />_ <br />t <br />i <br />ENVIRONMENTAL HEALTH DIVISION FILES <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOP) O HOUSIN'i ABATEMENT ❑ SOLID WA51tE PACIL r <br />❑,�CC77THER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY 17 SOLID WA$TE VEHICLI <br />USH <br />1UNDERGROUND TANK (MONITORING/REMOVAL) ❑ DOG KENNEL O DAIRY <br />O HAZARDOUS WASE GENERATOR O CHICKEN RANCH ❑ PKG I REWWENT PLANT <br />❑ TIERED PERMITTgD FACILITY ❑ MOTEU.IOTEL ❑ PUMPER TI tUrKUYARD/CHEM TOILETS <br />❑ TATTOOIBODY POIRCING ❑ POOLIs'A 0 LAND USE 4PPLICATION SITES <br />u^ MEDICAL WAST9 FACILITY C3 PUBLIC WATER SYSTEM C3 07141111 (PI.cASE. PECIFY ACIOVE) <br />1. List up to ten addresses in the space above. Select the type(s) of files ;iom tho licit above by checking <br />the appropriate box(es). At (cast one file typl: MUST be selected. Fax t, (:09;-464-0.138 or mail to tho <br />address indicated above. <br />2. EHD will notify the applicant if any EHD files •:xisL An appointment for revioYV will be confirmed <br />approximately five business days but no later than ten (10) days after roceipt c -f application. The files <br />will be hold for a maximum of five business days for review. Appointm�:nl:s should be scheduled <br />accordingly. <br />3. A file that is actively being worked on by EHCI 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 a:: released will be rcorgani _cd by EHD staff at the cxpunso <br />of the applicant. Futuro file reviews by the sz.me applicant may require a S87A 0 deposit: prior to review. <br />5. 'TENTATIVE appointment dates must be con'irmed with EHD staff. <br />G. Applications received after 3:00 pm will be plocossed the next business day. <br />CONFIRMED APPOINTMENT DATE <br />DATE CONFIRMED <br />. j. <br />REVIEWED 11 <br />YES NO <br />TIME <br />FHONE FAX <br />RFVIFW nATF <br />INITIALS <br />