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PM P2 <br /> FRl7M : NOR Environmental _ PHONE N0. 209 369 4228 Dec. 23 2002 12 EH 4OCC eU§Vk <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> r ENVIRONMENTAL HEALTH DIVISION 1091 i���� ' ( ( l�C�'I_%304 EAST WEBER AVENUE THIRD FLOOR <br /> 5TOCKTON CA 95202 <br /> �t 2 3 2002 (209)468.3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> ULi'lc it r ' <br /> APPLICANT �r' � . i'kA BUSINESSSIIAGENCY A/6K lcl;U.r0n111�1 <br /> ADDRESS/ <br /> PHONE `�00 31,7-3-70( rAcsimiLE�) 3'f-y7Z8 <br /> TENTATIVE'APPOINTMENT DATE Jam^" lOj z�0 3 TIME -!' W �' ' -�_'D <br /> (Please give 7 to 10 buslr s days from date of applle tion submittal) <br /> • <br /> El <br /> CHECK BOX TO EXPEDITE REQUEST-$89.00 FEE OCESSED IN 3 BUSINESS DAI� ' <br /> SIGNATURE OF APPLICANT - �RE STP DATE /Z / q <br /> Z <br /> FILE ADDRESS THIS SIDE END STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> \ -i at ^-f <br /> - o - <br /> a _tl 09.51 <br /> — <br /> =�e; -- <br /> 11 e2l <br /> GS <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> W OTHER CLEANUP SITE(NON-LOP) O FOOD FACILITY 0 SOLID WASTE VEHICLE <br /> JIT UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> S( HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> Cl TIERED PERMITTED FACILITY 0 MOTELIHOTEL PUMPER TRUCK",RDICHEM TOII_E7S <br /> ❑ TATTOO/BODY PEIRCING 0 POOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM U OTHER(PLEASE SPECIFY ABOVE <br /> 1- List up to ten addresses in the space above. Select the type($) of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Kax to (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 be 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 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 /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> G. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br />