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�.,r �.uu� ir. ut vovut oa LNVIKUNMLNIAL %T11 PAGE 01 <br /> DATE RECEIVED SAN JOAQUIN COUNTo ( c����5�l 1�/Pj ��_ . EI ONMENTAL HEALTH DE <br /> 304 PAST WEBER AVENUE,THIRD FLOOR <br /> AUG 16 2004 STOCKTON CA 95202 <br /> (209)468.3420 I \a J 9,3 \a L ) <br /> NMb, i;i PUBLIC RECORDS RELEASE APPLICATION <br /> \ <br /> Q <br /> APPLIICANTrJ�Ur� \7J SLQS-�� BUSINESSIAGENCY <br /> ADDRESS Vw \ �\�� S� "�"1�Or�'S`�J C.� `� S3S• (Fc�nc tS <br /> (PHONE 2 (i"\ LZ `'I \� FACSIMILE ZU <br /> TENTATIVE*APPOINTMENT DATE Q) Q4 S TIME <br /> (Please give 7 to 10 business days from date of application submittal) I <br /> CHECK BOX TO EXPEDITE REQUEST-$ FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> THIS SIDE EHD STAFF USE ONLY <br /> FILE ADDRESS PROGRAM ELEMENTS SEARCH <br /> \ LD W qn-ar b?t LOD'% urp <br /> tta Go a\ Lud ' L iG� Fad <br /> a M jL;Z�) <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> • UNDERGROUND TANK(UST)CLEANUP SITE(LOP) O HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> • OTHER CLEANUP SITE(NOWLOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> N UNDERGROUND TANK(MONITOR(NGTREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> O HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTEUHOTEL ❑ PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑ TATTOOIBODY PEIRCING O POOUSPA ❑ LANDJISE APPLICATION SITES / <br /> r2 MEDICAL WASTE FACILITY I <br /> OTHER(PLEASE SPECIFY) 1,k)(1 L n .-o Com'.i-P <br /> 1. List up to tan addresses in the space above. Select the type(s) of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to (209)464-0138 or mail to the <br /> address indicated above. ointment for review will be confirmed <br /> 2. EHD will notify the applicant if any EHD files exist, An ap j Ilcation. The files <br /> approximately five business days but no later than ten (10 day s after receipt of app <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 file reviews by the same applicant may require a$89.00 deposit prior to review. <br /> 6, '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 /> CONFIRMEO APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED �YES / / NO REVIEW DATE g <br /> y�zerzooi�-`� ' �7�/'/ �✓FJC �l("^ '�a 'J'oqojll U- 17, <br />