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09/03/02 07:35 FAVI; E.R.I. . `bw""1 <br /> ENVIR"ENTAL�W`hLTH PAGE 91 <br /> SALdOAQUIN COUNTYPU13LIC HEALTH`�ERVICES E�togaaNu ex <br /> } <br />�C ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOQR ' <br /> STOOKTON CA 96202 7 87 <br /> (209)468-3420 <br /> A177 PUBLIC RECORDS RELEASE APPLICATION <br /> F , <br /> ! APPLICANT 9US1N6S5(AGENCY <br /> i} <br /> II ADDRASS , 1�C. <br /> pHarrlr 1 FACSIMILE <br /> D <br /> 'TENTATIVE*APPOINTMENT DATE TIraE '�E P U 3 200z <br /> (Pieaso giv 7 to 10 burin days f data of a IlcaUon;ubmattal) <br /> r ENVIRONMENT HEALTH <br /> CHECK BOX TO EXPEDITE REgUES -S8?00 FEE_It <br /> EST p Ep! 3I�i1S1NE5S DAYS PERMIT/SERVICES <br /> SIGNATURE OF APPLICANT <br /> DATE <br /> FILJ$ADDRF-SS <br /> TINS$IDE EHD STAFF LISE ONLY i <br /> PROGRAM ELEMENTS SEARCH <br /> 202 <br /> W a m rrti r- cK <br /> h <br /> Fn <br /> P�- <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> 79=NDERGROUND TANK(UST)CLEA>k UP SITE(Lop) 4 HOUSING ABATEMENT CI SOLID WASTE FACILITY <br /> �v4TkER CLEANUP$ITE(Np1V-LOP) O FOOD FACILrTY ❑ SOLID WASTE VEHir <br /> >E4-UNnERGitOUND TANK(MONITORINGIRLEMOVAI,) EI DOC;KENNEL. 0 DAIRY <br /> LE <br /> ❑ HAZAR13OUS WASTE GENERATOR la CHICKEN RANCH ❑ PKU TREaTM> NT PLANT <br /> 0 TIERED PERMrTTED FACILITY .0 MOTBLIHOTEL ❑ PUMPER TR TRUGWY LANT EM TatLRrT5 <br /> Q TATTOOMEDICAL <br /> WASTE <br /> C] POpt1SPA Ct LAND USE Aj;iPLtCAnbN slrus <br /> ❑ MEpICAL WASTE FAGILI7Y C1 PUBLIC WATER SYSTEM 4 OTHER(PLEASE,SPECIFY ABOVE) <br /> I. List up to ten addressoi In the space above. Sele4t the type(&)of files from the lista <br /> abbove by cheaking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to 464-0138 or mail to the <br /> address indicated n . . <br /> 2. EMD will rtotlfy the applicant if any'RHD files exist; An Appointment for review will be confirmed <br /> approximately five husMess days but no later than ten(10)days after receipt of application. The files <br /> Will be held for a maxir Yarn of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that]s active) belt) works <br /> Y 9 d on by EHD staff may not be immediately available for review. Anew <br /> application may be su itted when the1 <br /> fi a is available. <br /> 4. Any file not returned ift 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 regUire a$8900 deposit prior to review. <br /> 5. "TENTATIVE appolntMent dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm wt!#he processed'the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> fir' T — <br /> • f: <br /> r <br />