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From: nJoCo-Oakland Office 510-33&9119 " Tami Date:4/16/2002 Time:4-1 '�2 PM ` A,0 <br /> Page 2 of 2 <br /> erre \%011 \ <br /> 04/16/2002 16:40 4640138 ENVIRONMENTAL HEALTH PAGE 01 <br /> uAc NtCrwMu <br /> SAN-JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> (209)468-3420 <br /> `P1UBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT �A \ W_fN--1 ti•N BUSINGSBIAGENCY 4E .J 0.J .•,t ea d l NC_ <br /> ADDRESS 1'1 Z 14'pt�L � _14,1.1Z <br /> i <br /> PHONE �p 3 1FACSIMILE (7)_ <br /> TENTATIVE*APPOINTMENT DATE ZS?A P.� ZLaZ TIME l�:.'3.�{�.••t <br /> ❑ ,, (PI47�t�7 0 70�Ines ram �piiCat' submittal) <br /> CHECK BOX TO FXPF134TE REGUE 9. UE OC 3I3U ESS DAYS <br /> SIGNATURE OF APPLICANT --u��-.�L� DATE4:11161n2— <br /> FILE ADDRESS THIS 91 E EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> --t•2 S <br /> � 3Szg L <br /> s� ,- e. <br /> ab it, Wt rJW -1( aL <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) E3 HOUSING A13ATEdENT ❑ SOLID WASTE ItACILr1Y <br /> OTHER CLEANUP SITE(NUN-LOP) ❑ FOOD FACILITY O SOLID WASTE VEHICLE <br /> NDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY O MOTEUHOTEL' ❑ PUMPER TRUCIUYARDICHEM TOILETS <br /> ❑ TATTOOIBODY PEIRCING d POOU8PA ❑ LAND USE APPLICATION SITES <br /> O NEDICAL WASTE FACILITY PUBLIC WATER SYSTEM O OTHER(PLEASR SPIICIFY ASOyE) <br /> 1. <br /> 'List up to ten addresses in the space above. Select the type($)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Faxto(209)4§4-0138 or mall to the V <br /> address indicated above. <br /> 2. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10)days after receipt of application. The files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that Is aptively being worked on by EHD staff may not be immediately available for review. A new <br /> application may be submitted when the file I$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 /> 6. Applications received after 3:00,pm will be processed the next business day. <br /> CONFIRMED'APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE •FAX INI'T'IALS <br /> REVIEWED. YES NO REVIEW DATE <br /> 9a� <br /> . h <br /> s <br /> a <br />