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04/15/2002 14:56 20941' 110- AGE STOCKTON PAGE 01/01 <br /> DATE RECEIVED (( � "U iuu Numura <br /> SAN AQUIN COUNTYPUBLIC HEALTI�RVICES� <br /> ENVIRONMENTAL HEALTH DIVISIONi <br /> 304 EAST WEBER AVENUE,THIRD FLOOR2 <br /> STOCKTON CA 95202 <br /> (209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION I, <br /> ACANT USINESSlAGENCY P� r <br /> ADDRESS t 1 d .1 <br /> PHONE o?DV10Oa. FACSIMILE ) Mrs <br /> TENTATIVE'APPOINTMENTI,DATE E+ Q rl TIME O •'�y x 60g /,(fir <br /> (Please`'. VPOFM— <br /> bual ys from to of app cation submittal) <br /> CHECK BOX TO EXPEDITE REQU T-$ eE TP I BUSINESS DAYS,. <br /> SIGNATURE OF APPLICANT DATE <br /> y/S` <br /> PILE ADDRESS <br /> UyLOW G <br /> t. <br /> V- .270 't � s c- <br /> pP o 3Y t, i <br /> D ae 111W-` <br /> r. if <br /> ,C I 3524 SS .2 <br /> /02 /1 6 771 CCC. <br /> ✓' 3st 4y- 24d <br /> I <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) 1 ❑ FOOD FACILITY - ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL O DAIRY <br /> HAZAROOUS WASTE GENERATOR 0 CHICKEN RANCH O PKG TREATMENT PLANT <br /> TIERED PERMnTEp FACILITY M MOTEL/HOTEL O PUMPER TRUCK/YARO/CHEM TOILETS <br /> ES <br /> O TATTOOIBODY PEIRCING C3POOLISPA O LAND USE APPLICATION ABOVE) <br /> 13 MEDICAL WASTE FACILITY 13 PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY AABO <br /> 1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checking <br /> the appropriate box(es).'l At least one file type MUST be selected. Fax to (209) 464-0138 or mail to the <br /> address indicated above. <br /> 2. EHD will notify the applicant H 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 available for review. A now <br /> application may be submitted when the file Is available. <br /> 4. Any file not returned in 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 require a$76.00 deposit prior to review. <br /> 5, '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 APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> A <br /> REVIEWED YES NO REVIEW DATE k <br /> i <br /> F.N ao 14 O�Nvoa - i <br />