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Mar . 5 . 2002 5:07PM Pn AOR EARTH TECHNOLOGIES No -8600 P. •4/4 03 <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES Pt <br /> ERVICEPt <br /> may/ I: ENVIRONMENTAL HEALTH DMSION <br /> a_ � 304 EAST WEBER AVENUE,THIRD FLOOR <br /> 0 STOCKTON CA 95202 <br /> Dz W a R _5 PH 4: 0 (209)468-342(l <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT,; q4J. ** BUSINESS)AGENCY— �[- -j�1T,� •q L <br /> ADDRESS IQiQ7 F ilk 2 5� r{ �e )' .11 l <br /> PHONE II FACSIMILE <br /> TENTATIVE-APPOINTMENT DATE i /LY/`� D'� TIME <br /> ❑ (Please itmess datsppliw ns�nal) ` <br /> CHECK BOX TO EXPEDITE REQUESTYIN/—Fi$ T t s 3 8 I S AYS AA � <br /> SIGNATURE OF APPLICANT DATE S-/�T(�l"�i O Z <br /> FILE ADDRESS THIS SIDE EHO STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> 163 der .1 <br /> II W (f - N <br /> 1-2-4141 urlALt Cr. <br /> o <br /> Al 5 <br /> t z7 3 <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> 10'UNDERGROUND TANK(LIST)CLEANUP srrE(Lop) M HOUSING ABATMWNT LY SOLID WASTE FACILITY <br /> 0 OTHER CLEANUP SI E(NON-LOP) ❑ FOOD FACILITY ❑ IID WASTE VEHICLE <br /> t9-UNDERGROUND TANK(MONITORING/REMOVAL) ❑ DOG KENNEL 1-k'DAIRY <br /> I0r-HA7ARDOU3 WASTE GENERATOR O-CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> L"IERED PERMITTED FACILITY IJ MOTEL/HOTEL ❑ PUMPER TRUCKIYARD/CHEM TOILETS <br /> 0 TATTOOIBODYPEIRCUIG ❑ POOUSPA ' CI LAND USEAPPLICATIONSITES <br /> I9"MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM 13 OTHER(PLEASE SPECIFY A§OVE) <br /> 1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checking <br /> the appropriate box(ez). At least one rile type MUST be selected. Fax to (209) 464-0130 or mail to the <br /> address indicated above. <br /> 2. EHD Wilt 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 files <br /> will 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 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; Future Me reviews by the same applicant may require a $87.00 deposit prior to review. <br /> S. '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 TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br />