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• i <br /> ZO'd _1I310I ., <br /> CATE ME iv <br /> 4A ,{ <br /> SAN JOAQUIN COUNTY. ElroLuc Hur♦aEa <br /> AL)G 1 2x,)03 ENVIRONMENTAL HEALTH bE'PARTMENT <br /> 3Q4 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> (209)4684420 <br /> PUBLIC-,RECORDS RELEASE APPLICATION <br /> APPLICANT /V e e BUSINE551AGEHr,Y !Q • 't1Q� <br /> ADDPMS <br /> PRONE —FACSIMILE <br /> TENTATIVE'RPPoINTMEN'TOATIE Alke aoj..�.003TIME ' D q <br /> (Please give 7 to 10 b6zIness da from date of'eppIja Ilan submiall) <br /> CHECK gOX TO.EXPEDITE REQUEST $119.04 FEE-REQUEST PROCESSED IN 3 BUSINl:55 DAYS ` <br /> 47� <br /> SIGNATURE OF APPLICANT aF DATE -0 <br /> FILE.ADDRESS "` THIS SIDE SHO STAFF USE ONLY <br /> PROGPAM ELEMENTS.SEARCH <br /> ,­`AAl .r .. .r <br /> X0 <br /> ML.- <br /> /f <br /> l <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(091)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT a SOLID WASTE FACILITY <br /> bbb OTHER CLEANUP SITE(NON-LOP) C1 FOOD FACILITY C1 SOLID WASTE VENICE <br /> UNDERGROUND TANK(MONrT091NGIREMOVAL) ❑ DOG KENNEI,• ❑ DAIRY <br /> .. O CHICKEN RANCH U PKG TREATMENT PLANT <br /> TIERED PERMITTED FAGIulY ❑ bIOTELlHO7EL ❑ PI11NplrR TR1ICKtYAI}DIGHEGt TOILETS <br /> a TAT100I5ODY PEIRCING Q POOLJSPA ED LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILrrY I7 07HER(PLEASE SPECIFY <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. Fax to 2091464.0136 or mail-to the <br /> address indicated above. <br /> 2. EHD will notify the applicant if any JEHO files exist.-An appointment for.review will be confirmed <br /> approximately five business flays but no later than ten(10)days after reCeipt of application. The files <br /> will be held for a maxlmum,df 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 raview. 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 applicalnt. 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 /> 61 Applications received after.3:00 pm will be processed the next business day. f <br /> POI ° :Xl <br /> ._'GQNfI_RNCED,.AP IYTMENT WE <br /> .- 1IIII1 <br /> DATE'G' 1,fF1RMD PHONE ;.FAX. - - INITIALS' <br /> REVIj�N D= "...:_.YI=S HO. ::RZVjE AF.0A_Tf -,. <br /> 7_0/zo'd 6tr99 .SI=6 LOL S d I 88WI39 LS:0 Z zooz-8S-onu <br />