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i <br /> 05105/2005 15:30 209-57S`?25 MODE<STO ATC ' PAGE 02 <br /> COM rercEtvEu _ <br /> SAN JOAQUIN COUNTY -7 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 EAST WESER AVENUE,THIRD'FLOOR <br /> STOCKTON CA 95202 `BEIM,,5 1_7 �8 <br /> (209)468-U20 <br /> PUBLIC RECORDS RELEASE APPLICA'n 0AOU1N Col)Nry <br /> 46 <br /> APPLICANT,DXN to SC1 NEA 7 �R THE NT <br /> r BUSINESSIAGENCY Q O <br /> ADDRESS mil LoNE &Lm Amo- <br /> PHONEFACSIMILE-(' S'kl • 2Z 7'S . <br /> TENTATIVE'APPOINTMENT DATE S ,2O•O TIME 10, (A <br /> (Please give 7 to 10 business from of application submittal) <br /> CHECK BOX TO EXPED&E R �� <br /> EQUEST•=89.00 FEE-REQUEST Pas �D IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT XQZ1 DATE —5�•05'-0%-. <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> M UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 13 HOUSING ABATEMENT D SOLID WASTE FACILITY <br /> IPL OTHER CLEANUP SITE(NON�LOP) 0 FOOD FACILITY El SOLID WASTE VEHICLE <br /> 9t UNDERGROUND TANK(MONITORINGlREMOVAL) 13 DOG KENNEL 0 DAIRY <br /> 0 HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH M PKG TREATMENT PLANT <br /> E3 TIERED PERMITTED FACILITY O MOTELIHOTEL 0 PUMPER TRUCKIYARDICHEM TOILETS <br /> TATTOOIBODY PEIRCING I7 POOLfSPA M LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY E3 OTHER(PLEASE SPECIFY) <br /> 1. List u to ten addresses in the space above. Select the 7 <br /> p p type(s)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the <br /> 94d_aM in <br /> 2. END will notify the applicant If any END 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 END 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 END 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 /> S. 'TENTATIVE appointment dates must be confirmed with END staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CQNFJRMED APPOINTwNr.oATE TIME <br /> DATtOONFIRMED PRONE: FAX INITIALS <br /> R VI D. YES NO REMEW DATE <br /> ry <br />