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`�3un 25 02 08. 46a p. 2 <br /> 06/25/2002 98:26 7138 N2-5 IRONMENTAL/ `%LTH PAGE 01 <br /> t;wFie <br /> "PSAN JO OUNTYPUBLIC HEALTHH SERNgCES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 FAST WEBER AVENUE THIRD FLOOR <br /> STOCKTON CA 95202 <br /> (209)460-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION � <br /> APPLICANT�/i Y_ffN L(f11CyA it BUSINESSIAGENCY /!tom t { <br /> ADDRESS LASSAve- vi C '70 q5 3 <br /> PHONE FACSIMILE <br /> 1 <br /> TENTATIVE*APPOINTMENT DATE � � °` TIME In ayy�--:l_ <br /> (P]ON670101i"t"RME <br /> adaysF dSIQ appilcm subm111a1) <br /> CHECK BOX TO EXPEDITE REQU9.04 OuE3T0 CAS1 , JS SS DAYS <br /> SIGNATURE OF APPLICANT it- DATE <br /> FILE ADDRESS THIS SIDE EHD STAFF USF:ONLY <br /> PROGRAM ELEMENTS SEARCH. <br /> t <br /> ')-!Il LCC dc V,4�zl CA <br /> i <br /> L L tj, 1 a u( fid. F_„ c <br /> i <br /> i <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> 0 UNDERGROUWO TANK(UST)CLEANUP SITE ILOP) 0 HOUSING A13ATEMENT W SOLID WASTE FACILITY <br /> 0 OTHER CLEANUP SITE(NON•LOP) 13 FOOD FACILITY 13 SOLID WASTE VEHICLE <br /> 0 UNDERGROUND TANK IMONIMRIN43IREMOVA13 0 DOG KENNEL E3 DAIRY <br /> O HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH . 10 PKG TREATMENT PLANT <br /> © YIQRED PERMITTEO FACILITY O MDTELIHOTEt ❑ PUMPER TRUCW YARDICHEM TOILETS <br /> 13 TATTOOIBOOY PEIRCtNG 13 POOLJSPA 0 LAME)U3E APPLICATION SUES <br /> 0 MEDICAL WASTE FACILITY O PUBLIC WATER SYSTELI 0 OTHER(PLEASE SPECIFY ABOVE) <br /> 1. 'List up to ten addresses in the space above. Select the type(s)of files from the list above by eheakirib. <br /> the appropriate box(es). At feast one lite type MUST be selected. Fax to(209)464-0138 or mail to the <br /> address Indicated above. <br /> 2. END will notify the applicant if any END riles 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 EHn staff may not be immediately available for roview. Anew <br /> appllcatlon may be submitted when the file is available. <br /> j 4. Any file not returned in the same condition as released will be rearganized by END staff at the expense <br /> i of the applicant. Future file reviews by tho same applicant may require a$B9.00 deposit prior to review. <br /> 5. "TENTATIVE appointment dates roust be confirmed with END staff. <br /> 6. Applications received after 3:00 pn1 will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE" TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> i <br />