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02 / 11 / 08 TUE 14 : 29 FAX 925 253 4985 TREADIVELL & ROLLO 0 001 <br /> IF- <br /> - E/ta tioc NUMueR <br /> SAN JOAQUIN COUNTYPU13LIC HEALTH SERVICES <br /> Fi_ B :I ; ` 003 ENVIRONMENTAL HEALTH • DIVISION <br /> 304 EAST WEBER AVENUE, THIRD FLOOR <br /> r_ -'1 H STOCKTQN CA 95202 151 <br /> (209) 468 -3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT OA irt�5 BUISINESSIAfGENCY � . lyQ� d,y�Y 41� p �� n <br /> v ' ADDRESS I Aafe. 2w o ( m) riy�� Q <br /> �(- <br /> PHONr: • L - L - 8o FACSIMILE � <br /> 9z�" <br /> TENTATIVE* APPOINTMENT DATEFSL e, <br /> . ._ t" e b LO TIME OG- Q �7j <br /> (please give T to 10 buslnoss days from data of appllcatlon subml (tal) • owl <br /> CHECK DOX TO EXPEDITE REQUEST 9.00 FEE r ft=,FkPUEST PROCESSED IN <br /> 3 BUSINESS DAYS u r <br /> 1 <br /> -j SIGNATURE OF APPLICANT <br /> FILE ADDRC55 THIS SIDE EHD SYYAFF USE ONLY <br /> PROGRAM 9LEAAIENTS SEARCI4 <br /> 41w > a eIR <br /> W �54 -L15c) I'r&.c rrq <br /> 57 W &t) t; <br /> � Li74w�s� • 4' S /'1? -- <br /> z3 S 7 gar ra <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK (UST) CLEANUP SITE (LOP) 0 HOUSING ABATEMENT 0 SOLID WA;iYE FACILITY <br /> OTHER CLEANUP S1TE (NOWLOP ) 0 FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK (MONITOR INGIREMOVAL) . 0 DOG KENNEL 0 DAIRY <br /> HA4ARDOUS WASTE GENERATOR 0 CHICKEN RANCH • 0 PKQ TREA'riHENT PLANT <br /> TIERED PERMITTED FACILITY L7 MOTELIHOTEL O PUMPER TIRUCKrYARD/CHEM TQI_ .IZT5 <br /> ❑ TATTOO/HODY PEIRCING 0 POOLISPA El LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY CI PUBLIC WgTER SYSTEM ❑ OTHER (PLEASE SpCCIFY ABOVE) <br /> 1 . List up to ten addresses In the space above . Select the type ( s) or files from the list above by checking <br /> the appropriate box( es) . At least one file type MUST bo selected . Fa_ x to (209) 464 -11138 or mail to ( he <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 riles <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 Js, actively bleing Worked on by EHD staff may not be immediately available• for review. A new <br /> application may be submitted when tho file is available. <br /> 4 . Any file not returned ih the same condition as reloased wilt be reorganized by .EHD staff at the expense <br /> of the applicant. Future rile reviews by the same applicant may require a $ 89. 00 dopositoprior to review, <br /> 5. "TENTATIVE appointment dates must be confirmed with EHD 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 <br /> ; REVIEW DATE �. r. <br /> 1 �n— � . <br /> Tn 0:1n"j UI 'IH7LJ 'M1k1'71A1A1r1)JTA1.1".] PPTGIbCIb Tb : gT 7. GIGI7. / 7. T. / TT <br />