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Jul 24 03 02: 46p p. l <br /> 07/24/2003 14:31 4640136 ENVIRONMENTAL HEALTH PAGE 01 <br /> N Luc wuwku <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 EAST WEBER AVENUE,THIRD FLOOR 2 <br /> STOCKTON 9 <br /> 42003 (2o9)afi6-3-3 42 <br /> 0 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> -4APPLICAIi�7F`3''ar "1 1 BUSINESSrfAGENCY Tn X I VL I ltG , <br /> ADDRESS II Ci s^/� Ci"C"A1 - I `'}e 7iQZ <br /> �i/ C \ T Iiiyr y ..s �Me 1 <br /> PHONE " J) s-� -4 d- c� ->? <br /> r FACSIMILE <br /> TENTATIVE'APPOINTMENT DATE :q- ZS 93 D— ' TIME q /� <br /> (Placa give 7 to 1 business days"in date of appllca(lon submlllal) • ^I <br /> y-' CHECK BOX TO EXPEDITE REQUEST-$99.00 FEE-REQUE((SS�T PROCESSED IN J BUSINESS DAYS. ' <br /> /SIGNATURE OF APPLICANT �G{i"11—�C� 1 -P DATE Z D 3 1'a�� l <br /> FILE ADDRESS THIS SIDE END STAFF U E ONLY 0 <br /> PROGRAM ELEMENT EARLU Q2 a4�&td CH <br /> ITT x) <br /> 3 n� u S <br /> z ( w LUST <br /> n7 5 <br /> lie xt s .s srl <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) D HOUSING ABATEMENT SOLID WASTE FACILITY <br /> 'GC.OTHER CLEANUP SITE(MON•LOP) 0 FWD FACILITY SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONrrORINGIREMOVAL) 0 DOG KENNEL 0 DAIRY <br /> 'L HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> O TIERED PERMITTED FACILITY O MOTELIHOTEL 0 PUMPER TRUCKtYARDICHEM TOILGTS <br /> 0 TATTO01800Y PEIRCING 0 POOLISPA LAND USE APPLICATION SPIES <br /> 0 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 to(209)464-0138 or mail to the <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 Ole that is actively being worked on by EHD 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 EHO staff at the expense <br /> of the applicant. Future Ole reviews by the same applicant may require a S69-OD 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 INrITALS <br /> REVIEWED YES NO REVIEW DATE <br /> rim wbz M <br /> Trscnow <br />