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11/10/2000 12: 42 209-579-2225 MODESTO ATC PAGE 02 <br /> Fr <br /> ';ijM� m-� FR01"� ' T U • 5'79 '?`r.5 P.EI'.. <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> NOV 10 2000 ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> ENVIRONTH STOCKTON CA 95202 <br /> � E �iW W- A (209)488-3420 <br /> PUBLIC RECORDS RELEASE/ 1 APPLICATION <br /> Llter�T K f/� " BU$INES5 (} <br /> /AGENCY A.A F o c-1,4 Its <br /> ,1 --_ <br /> AID_gS (Ia.' �,,'�tA-L J ,t"O.1 n u4'�Cvwi , S.Si(� �, �'1.tDWPSry CA <br /> .. v PONE k3°I 5-f-9- Zz't C FACSIMILE <br /> TENTATIVE*APPOINTMENT DATE IVQ7"' ��-K TIME I�� i3 <br /> (Plaase plve 7 to 10 business days from Qate of OPPIi"tian submittaU <br /> CHECK BOX To EXPEDITE REQUEST-37&00 FIE/§-REQUEST p OCE$$ED IN a BUSINESS DAYS I <br /> SIGNATURE OF APPLICANT V��� DATE <br /> FILE ADORES$ O <br /> +�1 Fc OF_ 2 O <br /> l m.I�n C-t�nlcr 51,v-tt♦,. S{-oLl44o�-+ <br /> 1 H1- so on Vada Si�cf 3t0cK��t e <br /> '� Y4l_ W. Utigfr4t✓ }Alas fvcl�l-on � r ' ` <br /> 4 t�Yl 440 UJ. Cltia.r�tr VJa f S}alKiv� w <br /> S Wer+ CIS✓ Wal. Slo�icla -` :::.:. ., N11 <br /> .w tib L ,.-Gc,�• W fnc.lc t .. i <br /> Q)LloTele_aS�,�✓ 'pa�id SX� () D ���D <br /> EN VIR$NMENTAL HEALTH DIVISION FILES <br /> UNOERGRWNC'•ANK(UST)CLEANUP$ITE(LOP) r- HOUSING ABATEMENT O SOLID WASTE FACILITY 1\101/ J <br /> OTHER CLLANUP SITE(NON-LOP) ❑ F000 FACILITY 0 SOLID WASTE VEHICLE <br /> 0 UNDERGROUND TANK(MONITORINGIRFMOVAL) O DOG KENNEL O DAIRY <br /> Z HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> U TIERED PERMITTED FACILITY ❑ MOTEUMOTEL ❑ PUMPER TRUCIVYARDICHEM TOILETS <br /> ❑ TATTOO/900Y FEIRCING ❑ POCL/SPA ❑ LAND USE APPLICATION SITES <br /> U MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM El OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to tan addresses in the space above. Select the typo($) of tiles from the list above by Checking <br /> tho appropriate box(es). At least one flim type MUST be selected. Eax to(2091 4¢4.0138 or mall to the <br /> address lndioatetl above <br /> 2- EHD will notify the applicant if any EHD files exist An appointment for review will be Confirmed <br /> approximately five business days but no later than ten (10)days after receipt of application. The file$ <br /> will be hold 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 EHD 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 expense <br /> of the applicant. Faure file reviews by the same applicant may require a $78.00 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 business day. <br /> I <br /> I CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWfiD YES NO REVIEW DATE <br /> \F 71 11 Otdfp: <br /> TOTAL P.02 <br />