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TO • 15S9L'ELfi7126 P.O� <br /> 10-17-26.100 10:2BM F* kNll\(Ai N1}M4L1, <br /> i,,,C AII.JV v <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION / �f <br /> 304 EAST WESER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> (209)466-3420 <br /> J PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT ��^Yi(-1 I�,J1]I �ec-c(_oc' �...euSINEs&AGENGY t W (,I-i "t Lj'-6CTfX <br /> ADDRESS-S`/7 S�r C7 vl0 frtTeG I (� <br /> PHONE Cl �Id� 70. 1 FACSIMILE <br /> TENTATiVE`APPOIRYMENT OATE TIME _ �' " -Y7 <br /> (Please Pius i to 1(ibuss esss7CESSED <br /> date of apPllcaGon SaLmittal) <br /> CHECK 301 TO ExPEDITE REQUEST-$37.01)FEE—RE�QU,EST P IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT 742�1_ ": DATE <br /> FILE ADDRESS TRg BIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> N <br /> 1'af dockPI 3sa Mr <br /> p W- Kclfl<.ti.an Lo.n lid; ^ t .29�� 3S2 <br /> 15 06 t/,nG ¢i e-(- Lz ; k S� <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) O HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> 13OTHER CLEANUP SITE(NONJ.Ap) ❑ FOOD FACILITY 4 SOLID WASTE YEHICt.F <br /> ❑ UNDERGROUND TANK(NONfrORINGIREMOVAL) O DOG KENNEL ❑ DAIRY <br /> 4 HAZARDOUS WASTE GENERATOR ❑ CHICKBN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTEL 0 PUMPERTRUCKrYARwcHEMT01 ET5 <br /> C TATTMUwODY PPIRCING 0 POOLISPA O LAND USE APPLICATION S(TES <br /> G MEDICAL WASTE FACILITY C3 PUBLIC WATER SYSTEM 0 OTHER(PLEASE SPGCIFY ADOYE) <br /> 1. List up to ten addresses in the space above. Select the types)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fox to fz09)464-0138 or mai(to the <br /> address Indicated above. <br /> 2. EHL)will notify the applicant H any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10)days after receipt of application. The files <br /> will be held for a maximum of five busineso days for review. Appointments should be scheduled <br /> accordingly, <br /> 3. A file that is actively being worked an by EHD staff may not be immediately available for review. A new <br /> application may be submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Furore file reviews by the same applicant may require a$BT.00 deposit prior to review, <br /> 5. *TENTATIVE appointment dates must be confirmed with EHD staff, <br /> 6, Applications redeived after 3:00 pm will be processed the next business day. <br /> I <br /> CONFIRMED APPOINTMENT DATE TIME <br /> I <br /> PATE CONFIRMED PHONE FAX INITIALS <br /> VIEWED YES NO REVIEW GATE <br /> a. �mm <br /> ( TOTAL P.02 <br />