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JAN-21-03 10:41 AM OXOXOXOX0 55'3-325 2297 P.01 <br /> 01121/2003 08:53 464 38 EHVIP0144ENTAL HeMtTH PAGE * 01 <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> �n C ( ,� r t <br /> ENVIRONMFNTAI.. HEALTH DIVISION <br /> I ` 304 EAST WEDET2 AVENUE,THIRD FLOOR <br /> J STOt K`TON CA 95202 3 <br /> JAN 2 1 203 (209)468-3420 <br /> PUB1,,1C RECORDS RELEASE APPLICATION <br /> r�L1t:ANT � r DUSINESSIAGENCY <br /> ADDRESS CR 5 fit..,1_ . f-rG s Y)r 'S+y-C C t- <br /> PHONsz O-N S'rl LI ._FAds1Mn F- _A5 <br /> TENTATIVE'APpOINTM6NTUnTF. � '~ T1MH <br /> (Pltaa*o1vR 7 in In business d:yi from date of npplleollen MWMI(lal) <br /> Q SH1:�G1S <br /> 11UTO rxpi nap nCQULCT noatcarn m 0 su'sweaS BRIS <br /> *SIGNATURE OF APPLICANT DATE <br /> Ft"ADDRESS 'MIS SIDE END STAFO USU ONLY <br /> PItOGkAM ELEMENTS SEARCH <br /> 1. l AoI t t. dL r tm e7 s ' <br /> L.oh+ <br /> SATIZ <br /> 3. V1G.rfevi <br /> _.. ... coo ,_.._c �ac`f.'�'r`"'S �:tc'. <br /> 77 A c i fi C"-eN <br /> S tr c.lCtc•.-� _ - — <br /> {:.,.. <br /> 46 u <br /> ll �. t•i 'e e <br /> �. C11", r6''1 SA-;rtih e-vN tL 1,.#171 3 5 <br /> (<4 3 3 lPA4i c: ENV i�ONk L HEALTH DM_ 5 �N3iLES <br /> UOUD <br /> UNOERGROUND TANK(UST)CLEANUP SITE(LOP) OUSINGABATCMFl1T sWASTE FACUL , : . �•! <br /> OTHER CLCANVP SITE(NON-LOP) <br /> F000 FACILITY O souo WASTE VEHICLE <br /> UNDERGROHND TANK(MhNITORINGjnFM(5VAL) f1 DOG KERNEL �❑,,/DAIRY + ': <br /> 0 C.HICKGN RANCH 4� PKG TRFATM€NT PLANT <br /> flAz oouS wAs7C Gr-NETtATOR ❑ MOTCLA14TC1. o ruutrt n TnU01WAttb►oltt;M Y0kLCTO., <br /> TIfiRiD P4RMITTY.O CAC1LrrY O pOOVSpA Cl LAND USc AppI.ICAI'ION SIt1 5 <br /> D TAT70WDODY PF_IftCING ATHER(PLEAS:sPECIsY Dove) <br /> D, MEDICAL WASTE FACILITY . sl7 f stz s. <br /> �s List up to ton addresses 1n the space above. Select the types?of files from tha lilt obove by ciTeehijr ,• <br /> the appropriate box(es). At least one rile type MUST be 591009d. Fex to f2091464.01i or ma(1 to the <br /> w address <br /> 2, EHD will notify the applicant if any EHD files exist. An appotntmant for review will be confirmed ;..; <br /> approximately five buslnoss days but no later than ton(10)days after rvcolpt of applieatlan..The iiia;;.; <br /> will be held for a maxtm4m of five,buslnoss days for review. Appointments should be sehodulod <br /> accordilTgty. <br /> 1. A fits that Is.actively belna.aarkod on by EHD staff may not be Immediately available for review. A nt <br /> Application may bo su4lnitled when the file is available. <br /> �.f. . <br /> 4. Any file not returned if%the came condition as relelmed will ho roorgOnIted by EHD shaft it thlu vAyd'li. <br /> of thea applicant. Future fila roviews by thv same 4,pplloent may require a$89.00 dopes;)t prior to rayl , <br /> PP . <br /> 5, 6TENTATIVe appointment dates must be confirmed with EHD staff. <br /> G, Applications received after 3:oo pm will be proeossetl the nUxt businq*s day- <br /> CONFIRMED APPOINTMENT DATE., _ TIME <br /> DAl'F GbNFIRMCP ___ _ PHONE FAX INITIALS <br /> .;i <br /> REVIEWED YES NO REVIEW 0ATE �'' <br />