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FRO[D NOA Environmental PHONE NO. : 209 369 4228 Aug. 22 2003 03:56PM P2 <br /> EMD we ku"ER <br /> SAN JOAQUIN COUNTYPUBLIC:HEALTH SERVICES <br /> AUG J Z003 HEALTHENVIRONMENTAL <br /> 304 EAST WEB R AVENUE,THIRD FLOOR <br /> SYOCKTON CA 05202 <br /> (209)4683420 <br /> PUBLIC RECORDS RELEASE APPLICATION 1 <br /> APPLICANT `� `^,�1 C'�\ SU8INEN/A0ENCY` ►V e'l <br /> ADDRESS Qa 1\ 'H 0kK c;I1 r, L.Ci�P L aCl 1 e <br /> PHONE 2--© ( �� n I l a 1 FACSIMILP <br /> P _ ea. <br /> TENTATIV>a'gPPplN7MENT SATE `15 P TOME <br /> (Plus•plvs 7 W10 buelnoss days from drat*of appliostion submitgq , <br /> CHECK BOX TO F�CF 0rM KEQUESY-i8p. Q E- QU J�CPSA&D IN BUSINEW Days <br /> SIGNATURE OF APPLICANT DATE <br /> FILA AD RlBs9521 <br /> 47)^ 52�� a P s 950EEI1D <br /> r&LEME'1 M SEARCH <br /> 2 52 L • d n <br /> ENVIRONMENTAL HEALTH DIVISION FILES J���ire±�••. � r`vS <br /> NDERGROUND TANK(USM CLEANUP lffl[(LOP) C HOUSING ABATEMENT ❑ SOLID wASTC FACILITY l� <br /> OTHER CLEANUP alit:(No"Op) ❑ FOOD FACILITY O SOLID VYA3TE VEHICLE <br /> XUNDEltoROUND TANK(MON"RINOIREMOVAL) ❑ DOCi KENNEL In <br /> HAZAROQUo wASTV GENERATOR ❑ CHICKIN RANCH ^ PUM ER TRUCNT ARMC <br /> ❑ nERr:n PERMnrMD FACILITY 0 MOTELIHPTEL C3 PUMPER�UCK/Y�►RC/IGHEM T01�STB <br /> ❑ TATTOO/BODY PPIRCING 0 POOLISPA D LAND USE APPLICATION SITLa <br /> C mloICAL WASTE FACILITY t7 PURLIC WATrxR SYSTEM 10 OTHER(PLEASE SPECIFY AiOVIF) <br /> 1. List up to ten addresses In the space above. Select the type(s)of file$from the list above by checking <br /> the appropriate box(es). At least one 1110 typo MUST bo teloctod. Fax to 4 -0138 or moil to tho <br /> addre2l Indicated a0ve. <br /> 2. EHO will notify the applicant If any EHD files oxlaL An appointment for review will be confirmed <br /> approximately five business days but no tater than ten(10)days after receipt or applicktion, The files <br /> will be held for a maximum of fire bu3iness days for rwvlew. Appointments should be scheduled <br /> aCcordingty. <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 eVallable. <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD sniff At the expense <br /> of the applicant. Future ills reviews by the same applicant may require a$88.00 dapOglt prior to review. <br /> 5. 'TENTATIVE 7lppolnttnont dAtoc must be conflfined with EHO staff. <br /> g, Applic-atiorts received after 3:00 pm will be pmressed the n•ft businoss day. <br /> F <br /> ONFIRMED APPOINTMENT DATE TIME 41_ <br /> TE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br />