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`�Y*2a/2001 08:24 FAX 209 9480" 00:, <br /> EBD LOG N M-M-R <br /> oATEREcFjVEa L, —_.SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> f ENVIRONMENTAL HEALTH DIVISION <br /> LD <br /> 304 EAST WE6ERAVENUE,THIRD FLOOR <br /> FEB 2 3 2D04 STOCICTON CA 95202 <br /> (209)468-3420 <br /> ENVIRONMENT HEALTH PUBLIC RECORDS RgLEASE APPLICA <br /> �l <br /> APPLICANT , /p C� 13USINESSIAGENCY e� <br /> .Z /✓7yrf f� frLre� � dcL�-3ra, CFa <br /> ADDRESS �y <br /> PHONE '? FACSIMILE / a <br /> �12, IIo 7 TIME /�' a <br /> TENTATIVE*APPOINTMENT RATE UA <br /> � (Please give 7 t4 i0 pusirieSS days fi OFn Cate of apPlipit <br /> tlon suhmkalJ <br /> :::5C11ECK BoxTO EXPEDITE REQUEST-SB7.00 FEE-R gUE3 PROCESS 1H3 SUSlN1=SS OAYS <br /> DATE TURE OF APPLICANT <br /> FILE ADDRESS THIS SIDL EI�D STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> i <br /> MG Resa.�G�s I S 33;z , r,I,a Avco-, G t+J - <br /> 00 <br /> - <br /> 5 - _-T- <br /> q,? <br /> 1 ' <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> g Uf[DERGROUNDTANK UST]CLEANUP 517E(LOP) CI HOUSING ABATEMENT f OLID WASTE FAGIL11Y <br /> ( ❑ FOOD FACILITY LID WASTE VEHICLE <br /> _,1�'OTHER CLEANUP SITE(NON-LOP) ❑ pG KENNEL � D URY <br /> UNDERGROUNA TANK(IIIIONITORINGIRPMOVAL} CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> �W,HAZARDOUS WASTE GENERATOR ❑ MPER TRUCKfYARDICHEM TOILETS <br /> ,e Tjr, ED PERMrErED FACILITY [3MOTELlHOTFL . <br /> O TATTOOrDdDY PEiRC1NG d' .OOLPSPA NAND USE A PPL1CATi4tI S1TES <br /> � IJT <br /> MFDICAL WASTE FACIY VPUSUC WATER SYSTEM Q OTHER(PLEASE SPECU:YABOVE) <br /> 1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checkirl5 <br /> the appropriate bOX(es). At least one file type MUST be selected. Fax to 209 464-0138 Or mail o the <br /> address indicated above.. <br /> 2. EHD will notify the applicant if any EHU files exist. An appointment for review will be confwMed <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• Ane' <br /> application may be submitted when the file is available. <br /> 4. Any file not returned in tho same condition as released will be reorganized by EHD staff at the expens <br /> of the applicant. Future file revlews by the same applicant may require a $87.00 deposit prior to revie' <br /> S. *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 RATE TIME <br /> RATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br />