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� d d L— J <br /> � J �I�MHEALTH DM`. <br /> RONMEN7AL HLT ,`)N : <br /> LQ <br /> 304 FAST WEBER AVENUE;THIRD EL .R <br /> J U L 2 5 2000 STOCKTON CA 95202 <br /> (209) 46811 <br /> ENVIRONMENT HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> c , BUSMESWAGE14CY T)dbla E - « `n , • }6si Cal1 � I rt c_ <br /> APPLICANT - - <br /> ADDRFS8 � nMlvi Ccmd/& a '�f} 9T& :7c) . . <br /> 3l1>z . <br /> PHONE 4 tce � Q — �� FACSIMILE 5162 3F - 834 <br /> _ <br /> TENTATIaV•-E' APPOINTMENT DATE "4 �4 [ gj TIME GNOON � Itl� <br /> (PlaI glue 7 YA ( smess days h date atapPO�on submitlaA) <br /> CHECK Box To ExP£Drm REQUEST - $78,00 FEE - REQUEST PROCESSED IN ] BUSINESS DAYS <br /> DATE c <br /> SIGNATURE OF AFPLMANT <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> (n(nO C 1 Y <br /> WIN <br /> IN <br /> StnliLL $f-.z1ia <br /> � y <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> ElHOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> y.. UNDFSiGROUND TANK (UST) CLEANUP SITE tL�l ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> ❑ OTHER CLEANUP SITE (NONILOP) ❑ p04 KENNEL CI DAIRY <br /> ge. UNDERGROUND TANK (MONITORINGIREMOVA� ❑ CHICKEN RANCH ❑ PKO TREATMENT PLANT <br /> O HAZARDOUS WASTE GENERATOR ❑ MOTELlHOTEL ❑ PUMPER TRUCr4YARDII TOILETS <br /> ❑ TIERED PERMITTED FACILITY ❑ LAND USE APPLICATION SFI <br /> ❑ TATTOO(BODY PEU2Q NG ❑ PI ❑ OTHER LEASE SPECIFY ADOVE) <br /> L7 pUBLIC WATER SYSTEM <br /> ❑ MEDICAL WASTE FACILITY {P <br /> 7 . List up to ten addresses in the space above. MUST be selected. Faxflie ( 464,9138112091 e11st above by nd-0938 or maclttocttiee <br /> the appropriate box(es). At least one file type <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 files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that Is actively being worked on by EHD staff may not be immediately avallable for review. Anew <br /> application may be submitted when the file is available. <br /> 4, Anyfile not returned In the same condition Its released will be reorganized by EHD staff at the expense <br /> of the applicant Future file reviews by the same applicant may require a $78.00 deposit prior to review. <br /> s. ' TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6, Applications received after 3:00 pm will be processed the next business day, <br /> CONFIRMED APPo)N'TNIENT DATE TIME <br /> INITIALS <br /> DATE GOt1FIRPrtELt PHONE FAX <br /> REVIEWED YES NO REVIEW DATE <br /> eN ca to a <br /> TQTRL P , 02 <br />