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FROM Geo-Phase Environmental Inc. FAX NO. : 2095690295 Jul. 19 2002 04: PM <br /> SAN JO ., <br /> AQU TYPUBL_IC HEALTH SERVICt <br /> IF,/ <br /> TAL_ HEALTH DIVISION ��� _(�[J E D <br /> y 0 1 EBER AVENUE,THIRD FLOOR l <br /> } <br /> STOCKTON CA 95202 <br /> (209) 4GB-3420 JUL 2 2 2002 <br /> PUBLIC RECORDS RELEASE APPLICATf �'ROINQMEANTHEA <br /> APPLICANT v / LTH <br /> /�Q'7f rG� 6U5INI:S5/AGENCY G. S <br /> ADDRESS 93 7e,..Trz <br /> /- � r/G S <br /> PHONE 6714 <br /> FACSIMILE <br /> TENTATIVE"APPOINTMCNI'DATE <br /> {Please dive to 0 business da rom a of ap ' TIME <br /> cal on submittal) <br /> CHECK 5OX TO EXPEDITE REQUEST. � � <br /> $07.00 Fl k-REQ Ul:S71'ROCESSI_D IN USINES5 DAYS <br /> SIGNATURE OF APPLICANT <br /> DATE <br /> I FILE ADDRESS THIS SIDE END STAFF USE ONLY <br /> PROGRAM ELEMCNTS EARCH <br /> !70 <br /> ) <br /> f ' <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) CI HOUSING ABATEMENT ACILITY <br /> OTHER CLEANUP SITE(NON-LOP) FQOD FACILITY p <br /> UNDERGROUND TA ❑ SOLID WASTE r' <br /> l7 <br /> NK(MONITORING/REMOVAL) O DOG KENNEL SOLID WASTE VEHICL[ <br /> HAZARDOUS WAS�`E GENERATOR ❑ DAIRY <br /> O TIERED PERMITTGD FACILITY O CHICKCN rtANClI O PKG TREATMENT PLANT <br /> ❑ TATTOOIBODY PJIRCING q MOTEUliOTEL O PUMPER TRUCK/YARDICHEM TOILETS <br /> Cl MEDICAL wAs-rd FACILITY ❑ pDOU5PA O LAND USE APPLICATION SITES <br /> 0 PUGLIC WATER SY5.TEM Q OTHER(PLCASE SPECIFY AbDVC-) <br /> 1• List up to ten addresses in the space above. Select the t e s of files from the list above by checking <br /> yp <br /> the appropriate box(es). At least one filet e MUST be selected. Fax to 209 4G4-01313 or mail to tile <br /> address indirateCl 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 ton (10) days after receipt of application. The files <br /> will r held for a maximum of five business days for review. Appointments should be scheduled <br /> accordincdly. <br /> 3. A file that is actively being worked on by EHD staff may not be <br /> application may be submitted when the file is available. )mmediatply available for review. Anew <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 /> 5. `TENTATIVE appointment dates must be confirmed with EHD staff. <br /> Applications received after 3;00 <br /> p1T1 Will be processed the next business day. <br /> I <br /> CONFIRMED APPOINTMENT DATL; <br /> TIME <br /> DATE CONFIRMED <br /> j PHONE VAX INITIALS <br /> R1:VII;WED YES <br /> NO '�"—�--- <br /> �H oo t� .oaorroo REVIEW DATE <br />