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05/01/2083 08:34 2094678 <br /> ..•••••••�••••• AGE STOGCTON PAGE 1e1/01 <br /> SAN JOAQUIN COUNTY �oLOG <br /> nuwwt <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> MAY 0 1 2003 STOCKTON CA 96202 <br /> . (209)4663420 <br /> : 4--N r;EALRUBLIC RECORDS RELEASE APPLICikl-ION ' s <br /> APPLICANT BUSINESS/AGENCY 'ar) -6'0 P-Alll= <br /> ADDRESS <br /> PHONE Oq – in FACSIMILE �• <br /> TENTATIVE*APPOINTMENT DATE TIME <br /> (Please give 7 to 10 busin"s dqa from dile of nWicaftn sua»ftFa %' (J <br /> CHECK BOX TO EXPEDITE REQU 89.00 FEE–REQU T PROCESSED IN 3 BUSINESS[SAYS <br /> SIGNATURE OF APPLICANT DATE %4 <br /> FILE ADDRESS -'rHl§SIPF EHD STAFF USE ONLY <br /> .PFMPAIN ELF. S SSWCH- <br /> } <br /> 1n <br /> It It lr .r <br /> lE <br /> .. y I <br /> � h <br /> 0a" dLet <br /> trial Witt havc oLt-sik. ENVIRONMENTAL HEALTH DIVISION FILES s vl� prF �s11O.Z 4ID " <br /> . <br /> UNDERGROUND TANk(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ S(MI WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ S(X"WASTE VEHICLE <br /> UNDERGROUND TANK(MONRORING/REMOVAL) 4 DOG KENNEL ❑ DiURY <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PI(G TREATMENT PLANT <br /> G TIERED PERMrMD FACILITY ❑ MOTE(JHOTEL ❑ PI110>E11 TRUCWYARD/CHEM TOILETS <br /> ❑ TATTOO/BODYPEIRCiNG ❑ POOL/SPA ❑ UWD USE APPLICATION SITES <br /> ❑ MEDICAL.WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <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). At least one file type MUST be selected, Fax Io(209)464-0138 or mall to th2 <br /> address indicated abcv_e <br /> 2• END will notify the applicant If any END files exist. An appointment for review will be confin-ned <br /> approximately five business days but no later than ten(10)days after reoaipt 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 END staff may not be Immediately available for review. A new <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 END staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a$119.40 deposit prior to review. <br /> 5. *TENTATIVE appointment dates must be confirmed With END staff. <br /> 6. Applications received after 3:00 pm will be processed the next business clay. <br /> COED APPOINTMENT DATE TIME- <br /> .DATE 4001FiRMED PHONE FAX INTI IALS <br /> YES NO REVIEW DATE <br /> i4b 44R-Mi <br /> arJ#120U <br />