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5 <br /> 09/17/2003 09:-35 FAX 209 9480621 , 16002/004 <br /> DATE RECEIVEDten6 LOG nuneER <br /> -- ; j'�v - SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES r <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> SEP 1 7 2003 STOCKTON CA 95202 <br /> (209)4683424 <br /> S,rIzU�1PJ1EN1 KbIll"PUBLIC RECORDS RELEASE APPLICATION <br /> I3 , <br /> APPLICANT �r\J1p--L S:U- PE .� BUS1NESWAGLNCY �� ►sf'cLZL-(Z <br /> A 30 ESS <br /> PHONE -2L)Cl l C7LUEd- 1-3 L157 FACSIMILE "1 L)& ZI <br /> TENTATIVE'APPOINTMENT DATE ��3 TIME f 2,� <br /> (Please give T to Ito 10T days from date of¢Ippilcation suCm tial) <br /> CHECK Box TO EXPEDITE REQUEST•4 7.00 F —REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE I �� �� <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY i t <br /> PROGRAM EI F-MENTZ SEARCH � <br /> vfz 3<- I je A 3 <br /> 2 CA 1P I V V'�L 0 a •� �, 3 <br /> C 0 At !t it04 <br /> 1 1 1 1 V 1i <br /> �r �1 <br /> It fir <br /> ('f'_./" jam//�'��• f <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> M UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT 0 SOLID WASTE FACILITY r, 7 J-1 ;;;.� �/►R�r,�f<:,. ,r.. <br /> R OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY la SCUD WASTE VEHICLE <br /> UNW211GROUNM TANK(MONITORING/IEMOVAL) ❑ DOG KENNEL 01 DAIRY <br /> I-VkZARDOUS WASTE GENERATOR ❑ CHICKEN RANCID W PKG TFtEATME W PLANT <br /> d TIERED PERMITTED FACILITY ❑ MOTELIHOTEL 0 PUMPER TRUCkjYARDICHENITOILETS <br /> ❑ TATTOOfBODY PEIRCING ❑-PdOLISPA ES'LAND USE APPLICATION SITES <br /> E3 MEDICAL WASTE FACILITY O PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses In the space above. Select the type(s)of files from the list abovi by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to 209 464-0138.or mall to the <br /> addressJndicat~ed above,. <br /> 2. EHL]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 files <br /> Will be Meld for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that Is actively being worked ori 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 file reviews by the same applicant may require a$87.00 deposit prior to review. <br /> 5. `TENTATIVE appointment dates must be confirmed with EHD staff_ <br /> 6- Appileatlons received after 3:00 pm will be processed the next business day. <br /> F CONFIRMED APPOINTMENT DATE TIME,. <br /> DATE CONFIRMED PHONE FAX IN11TIALS <br /> REVIEWED YES NO - REVIEW DATE J <br />