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09/16/2005 13:30 2094728E PAGE 02/02 <br /> 4640136 EWIROWENTAL HEALT6.,�= PAGE 02 <br /> v O+u bac Awuafn <br /> SAN JOAGIUIN COUNTYPUSLIC HEALTH SERVICES 1 <br /> SEP 6 2005 M ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WESER AVENUE,THIRD FLOOR ! <br /> ENVIR0Pd11,,%PdT IiEALTH STOCKTON CA 95202 <br /> PER';.it ERVIGES { 09)46e�420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT ori �usiFrEssrA�r`xc}r���i T--� nV_Y'C1Y�Wz e�_ <br /> ADDRESS�rn�y�Q.J OXY�,SCJ_ Y 1�t v-" <br /> PHONE -7'Z - '`q 2.O_FACSWILE <br /> TENTATIVE'APPOINTIONT DATE A5 __ r we . <br /> oneaOe 0"7 to 10 t"aft esa&A kom date of aM ttcatton rubmIttalj'�• <br /> SIG>' CHECK BOX Z 0 EXPEOtTE REquESY- S9.00 -R t;ESSFD IN 3 SUS(NESS DAYS l <br /> 11NATURE OF APPLICANT <br /> FILE AO S THrS SiDE EFg7 5TAFF M ONLY <br /> pnmRAM ELEMENTS SEARCH <br /> rv�er <br /> _-41 , . sT <br /> Arco <br /> ENMONitlIENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEMUP SITE(LOP) In HOUSMS ABATEMENT G SOLID WASTE FACILITY <br /> R CLEANUP SITE(Mq 4. OP) 0 FOOD FACIIJIT o Som wAST6 vEHicu <br /> UNDERGROUND TANK(i1tONIT0ltMIREM NAL) ❑ WO KSNNE'L G DAIRY <br /> Cl AZARDt7U5 WASTE GEiiSftATOR O CHICKEN RANCH o PKG TREATMENT PLANT <br /> Q Y1ERE0 PERMt rTED FACiUIY D MOTELMOTEG ❑ PUMPER TRUCIWARD/CHEtA YOtt.EYS <br /> ❑ TATTOWBODY PEi FACT O POOtJSPA D LAND USE APPLICATION 9"tS <br /> Q TATromEor.AL ODYWASTE IRCIN1'tt► ti ❑ PUBL.IC WATER SYMTEM O O114ER ML Mt SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above- Select the type(s)of files from the list above by chOCking <br /> theappropriate box(es). At least one file type MUST be selec ted- Fax to 209 454-0938 or alail to the <br /> drP�L ss insUr-atet abbye, <br /> 2. EHO Will notify the applicant if any EHD fines exist. An appointment for revia of ill��� TM files <br /> approaisnatei(y five btutainess days but no later than ten(90)days after receipt pp <br /> will be held for a maxlmum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A rde that is activelY being w°rt6d on by CMD staff may not be immediately available for raviehN. Anew <br /> appliCntion may be submitted when the file is avpileblee. <br /> 4. Any file not returned in they same condition as reieasod will tae reorganized by 15HD staff at thO expensa <br /> of the applicant Fl tuft file reviews by the Cattne applicant may require a$89.00 deposit prior to review. <br /> 5, "TENTATIVE appoin".ant dates must be Confirmed with END staff. <br /> G. 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 F"EW HATE _ <br />