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U1/(14/U2 -tl:4u rAe qla 161 <br /> 01/04/2002 15:41 a6aB130 ENVIRONMEtJTAL <br /> DATE PECEvEe � EMD L�NUMafR <br /> SAN JOAQUIN COUNTYPUB LIC HEALTH SERVICES, <br /> AI.1 H ENVIRONMENTAL HEALTH DIVISION A- <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> /r STOCKTON CA 95202 <br /> 02 JAN -7 Ali 8: pp (209)468.3420 <br /> I _ PUBLIC RECORDS RELEASE APPLICATION 1 <br /> APPLICANT, I�/� - .f�i ��� tT BUSIN�E5y5l�A�GE�NyCY �V�/�� 7- ,tid <br /> � <br /> ADDRESS {�/MpBG�`f Dr �YV c�r�y y6JJt/ti7�1 vUJ W, + f l <br /> PHONE 4-t 6- —TU I —:?--q ©I) FACSIMILE �_ ` t-s^� �Co�• -r <br /> TENTATIVE'APPOINTMENT DATETO(- t 2062 TIME /b •O G 'r"k <br /> (Pleasa give 7 to 10 bus�ineaa days from date of application submIU0 <br /> �/ y- <br /> CHECK BOX TO EXPEDITE REQ - 9.e0 FEE ST Pj2 ESSED 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> FILIS ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELIiMENTS SEARCH <br /> O A S 3S <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> ❑ HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELJHOTEL- ❑ PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑ TATTOO/BODY PEIRCING ❑ POOLISFA ❑ LAND-USI?APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above. Select the typs(s) of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax tc 209)464-0138 or mail to the <br /> address indicated above. <br /> 2. EHD will notify the applicant If any EHD files exist. An appointment for review will he 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 maybe 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 889-00 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 /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INfrIALS <br /> REVIEWED YES NO REVIEW DATE <br /> 4"1i 6 - <br /> R6MtED1Id7-01 <br />