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DA. RECLIVED <br /> SAN JOAQUIN COUNTY LHU LUG iVlli 4;LH <br /> El''iRONMENTAL HEALTH DEPAITI'i ENT <br /> 304 E Weber Ave 3`1 Floor Stockton, CA 95205 <br /> DEC 12 2089) 465-3420 Fax: (209) 464-0138 Web: www.co.san-joaquin.ca.us/slid <br /> '�' } `IIYi Fs lictil(i'I PUBLIC RECORDS RELEASE APPLICATION <br /> A?PLICANT: C/G� L BUSINESS/AGENCY: -z/ �- "�(�✓✓s �fl� <br /> ADDRESS: a.�oZ��, <br /> PHONEA; 2e (Ol!,-, I FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from dale of application submit 1) My <br /> C1 CHECK BOX TO EXPEDITE REQUEST-$93.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT�yt���Q i2Q� DATE Lot LLD <br /> (9 G,� - Department Use Only <br /> FILE ADDRESS UNIT <br /> stce� . I G• U�./L p., <br /> s�rc<iG• <br /> 3. suer, - Uy <br /> Gry 1j <br /> Unit 2 Il,a� <br /> s steel G Unit 3 <br /> 6 steel ON <br /> r veep G' Unit 4 <br /> a ste0 e, <br /> 3 steel Oly �Unit 5 <br /> t0 51eei ON <br /> V� <br /> CP/�"�—. <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES t� <br /> j� UNDERGROUND TANK(UST)CLEANUP SITE (LOP) ;2r HOUSING ABATEMENT 12' SOLID WASTE FACILITY <br /> .� OTHER CLEANUP SITE (NON-LOP) Rr FOOD FACILITY SOLID WASTE VEHICLE - _ w <br /> I� UNDERGROUND TANK(MONITORINGIREM OVAL) ?I DOG KENNEL �'DAIRY rL4,t_IL /j <br /> HAZARDOUS WASTE GENERATOR CHICKEN RANCH (;f PKG TREATMENT PLANT <br /> 0TIERED PERMITTED FACILITY 3-MOTELIHOTEL gr PUMPER TRUCKIYARDICHEM TOILETS <br /> PI TATTOOIBODY PIERCING ET POOLrSPA Lx LAND USE APPLICATION SITES <br /> yJ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <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 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. i <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 $93.00 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 INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> n0 efiaaa06 <br /> v&7003 <br />