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.iKlL I�uu�l>/4 �. •.• `-_ __ _. _ _ _ �,�r:� �ri'v IrU �;l. Li. <br />SAN. JO,�Q,_ A COUNTYPUBLIC HEALTH SERVi�_S <br />E-NVIELONMENTAL HF-:ALTH DIVISION <br />304 FAST WEBER ""NUE, THIRO FLOOR LTO <br />STOCKTON CA 85202 <br />(208) 46B-3420 <br />PUBLIC, RECORDS RELEASE APPLICATION,fl, <br />APPLICANT "ti,L�O BUSINE$SIAOENGY ee <br />` ADDRL55. 05� Co�11��c,A1. C,e`C_LE ,)Q<gV_b, Ca T,62'0 -- _ MAY 7 2001 <br />PHONE <br />C j'- b�U" � `� FACSWILE <br />TENTATIVE APPL _ ,,�,,� PFR."' iT!:.I_f `JIC FS <br />!N YL41; NT Dia T -E _T _ <br />01Ie35e give T 10 10 bctsiness days from da(P aF a 11e;a6w aubmiMl <br />CHECK BOK TO EXPEDITE RCQURST ! Ft:C REQUEST PROCESSED 1N 3 8USI1ii=55 LAYS <br />AS1GNATLIRE OF APPLICANT DATE —T Q I <br />FILE AGL1REsS <br />I <br />THIS SIDE Et -10 STAFF USE ONLY <br />PROGRAM ELEMENTS SEAKCH <br />3Zo � 1 0 Wbk cA <br />5. (e Ali a-") <br />9 <br />o t I L 351, .2386, 230A ?5-3/ <br />�!'to Z 8�1 1G /B':�..�361 Z2Zo <br />'I tJ �(, i <br />I.5 cEart -Vio <br />(0WE orI­0-1r11,VLvr0 ftoo wo4v bvt FIICILITy . <br />10 "A 5. Ae <br />111 5 n arra ,2 <br />0 <br />Ef VIRONMENTAL HEALTH DIVISION FILES v m O 2001 <br />UNDEIRGROUND TANK (UST) CLEANUP SITE (LOP) M HOUSING ABATEMENT )d SOLID WASTE FACILITY <br />OTHER C1 FAhUY STYE (NON -LOP)' LJ F017n FACIL" SOLD WA$TR VEHICLE <br />UNDERGROUND TANK (NIONITORIN&RE140VAL) C3 CLOG KENNEL O DAIRY <br />HAZIARDOUS WAaTE GENERATOR D CHICKEN RAi`1GH ❑ PKOTREATMENT?LA.YT <br />TIERCA PERMUTED FACILITY O MOTEUHOTEL ❑ PUMPERTRUGKlYARWCHEpd TOILETS <br />❑ TATT00f&ODY PEIRCING ❑ POOLISPA 177 LAND USE APPLICATION SITES <br />h1EDlCAL WASTE FACILITY O PUUM WATER SYSTEM ❑ OT"R (PLEASE SPECEFY ABOVE) <br />1. List up to ton addricsses in the space above. Select the type(s) of files from the list above by clreckin9 <br />the appropriate box(es). At'Jeast one file type W ST be selected. Fax to (208) 46440138 or mail to the <br />address indicated above. <br />2. EHD will notify the appilGant if any FHD 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. 11eld for a maximum gf five business days for review. Appointments should be scheduled <br />accordingly. <br />3. A file that iS aCtively being worked on by AHD staff may not be immediately available for review. Anew <br />application may be sub"tfed 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 expenGa <br />of the applicant- Future flleir"iews by the same applicant may require a $87.00 deposit prior to review. <br />5. 'TENTATIVE appointment dates must 130 confirmed with EHD staff. <br />F. Applications received after 3-00 pm will be professed the next buslness day. <br />CONF(RM-Ea APPOINTPAENT DATE TIME <br />DATE CONFIRMED Pilo ,IE FAX INITIALS <br />1 i _ <br />REV<E�VED YES NO I REVIEW DATE ' <br />Dt oc a aalci�co - <br />TOTAL P.01 <br />