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09/17/2003 09:37 FAX 209 9480611 U 004/004 <br /> DATE REC&F sa `✓ �,,,,' <br /> EMU TAG Numam <br /> SAN JOAQUIN.COUNTYPURLIC-HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH'DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> SEP 1 7 2003 STOCKTON CA 95202 f <br /> (209) 468-3420 <br /> ,_1W1RQNMFNl-HEA[ -H PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT _'j I �i PSC?t fr` _BUSINESS/AGENCY <br /> ADDRESS <br /> PHONE ZL-)o? CiLoo n q �- ^,FACSIMILE Zy 4k gNtb <br /> TENTATIVE"APPOINTMENT DATE ��O TIME Z OL-_' <br /> (Please Blve 7 to 10 business days from date of application submittal) <br /> CHECK BOX TO EXPEDITE-REQUEST-581.00 F QUEST P CESSED IN 3 BUSINESS DAYSLip fit <br /> ^� <br /> SIGNATURE OF APPLICANT DATE ( 7• e-3 <br /> FILE ADDRESS THIS SIDE EHD STAFF USE QNLY <br /> PROGRAM ELEMENTS SEARCH <br /> ✓✓ Lf 0 nd. VA--N! L r 1, L <br /> I L41a J s` ,, & <br /> I 3VO ►( <br /> 3 Z N - wt1L1Z)" WA <br /> i✓ ,, <br /> (0 214 A t PtJE. v ., A-k 211,6 <br /> 33 oZ ,. . , icy;-1:�•f`� / <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> 14 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) LI HOUSING ABATEMENT $3 SOLID WASTE FACILITY � <br /> 1�1 OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACIL(TY ❑ SOLID WASTE VEHICLE <br /> f� UNDERGROUND TANK(MONrroRING/REMOVAL) ❑ DOG KENNEL W DAIRY <br /> IP HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH 10 PKG TREATMENT PLANT <br /> C1 TIERED PERMITTED FACILITY ❑ MOTELmOTEL ❑ PUMPER TRUCKlYARDICHEM TOILETS <br /> ❑ TATTOOP300YP51RCtNG 0-PO0(j$PA' 0-LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY C1 PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses In the space above, Select the 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 th_e <br /> .ddress 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$87.00 deposit prior to review. <br /> 9. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3;00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME. <br /> DATE CONFLRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br />