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_ ti ^I <br /> "_FROM Geo-Phase Environmental T FAX NO. : 2095690295 ( �n. le 2003 04:21PM P <br /> SAN JOAQUIN COUNTY?UBLIC HEALTH, SERVICE': I <br /> ENVIRONMENTAL HEALTH DIVISION <br /> - 301 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95702 <br /> ,SUN 1 8 2003 (209)46c73420 13 0 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> OkPK,10;AXRVl��'l1�---- f,Dw• GY'G � BUSINESSIAGENCY <br /> ADDRESS <br /> PHONE �� ,' 0R 9 — _ _ --FACSjMlIL5 <br /> TENI'i ATIVE'APPOINTMCNT DATL 4r1-2 51TIME � jf <br /> (Picaac ryivc 7 to 10 bujincss days rrGi11 data or appticatian submitl�d) <br /> 9 CHECK BOX TO,CXPEDITE REQUEST-$01.00 FEE-REQUEST PROCESSED IN 3 i3USINLSS 0.4M _ <br /> J <br /> SIGNATURE OF APPLICANT �. � � _ DA,I E <br /> FILF ADDRESS TlilS SIO ii CC.>{i7:irAPP US>"ONLY <br /> PftOGR.,M ELEAIENTS SEARCH <br /> ,- A 0'/Z* <br /> a <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> Pe UNDERGROUND TANK(UST)CLEANUP SITE jLOP) ❑ HOUSIt G ABATEMENT 4 SCILJO WA::TE FACILITY <br /> O OTHER C1.L-ANbP SITE(NON•LOP) ❑ FOOD FACILITY ❑ SOLID WA:iTE VEHICLE <br /> 94 UNDERGROUND TANK(MONITORINGIRE:MOVAL) ❑ DOG KFNNE _ ❑ DAIRY <br /> n HAZARDOUSWAS O CaICKN RANCH ❑ <br /> } GrzArlENT PLANT <br /> PERNlT6 E GENERATOR <br /> ❑ TIERED <br /> FACILITY ❑ td TELHO?EL ❑ FLIMPER TRUCIQ'fARL <br /> 0HE?4 TOILETS <br /> Q .TATTOOIBODY P14IRCING ❑ P60LISPA Q LANC USE APPLICATION SITES <br /> 0 MEDICAL WASTE'FACILITY O PUBLIC WATER SYSTEM O 01-HER(PLEASE SPE(:II=YAGOYC} <br /> 1. List up to ten addresses in the space above, Select the types) of files from the list above by chccking <br /> the appropriate box(es). At least one file typo MUST be selected, Lax tt1f7091 4634-0138 or mail lo the <br /> f address indicated above. <br /> 2. EHD wilt notify,the applicant it any EHD files Ixist. An appointment for re)riew will be confirmed <br /> approximately five business days but no later-than tent(10) days afterrvCE!ipt (,f al)Alical.ion.-The.filcs <br />` will be held for a maximum of five business clays far review. Appointmcnts should Ile scheduled' <br /> accordingly. 1 <br /> 3• A ftic that is actively being worked on by EHG staff may not be immediately availal)lc for review. Anew <br /> application may be submitted when the file is availablo. <br /> 4. Any file not returned in the same condition a:released will be rcorcganf:cd by _'HD vtaff at the expense <br /> of the applicant. Futurc file reviews by the samo applicant may require 7 deposit prior to review. <br /> 5• 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 8. Applications received after 3:00 pin will be processed the next business; day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> E DATE CONFIRMEDAX <br /> REVIEWED 'u YES N REV1E DATE ' <br />