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ai <br /> 08/28/2002 16:53 209• -'9-2225 MODESTO ATC <br /> PAGE 01 <br /> uC ,ti. <br /> SAN•JOAQUIN COUNTYPUBLIC HEALTH SERVIC <br /> ENVIRONMENTAL. HEALTH DIVISION RD <br /> EB �( <br /> 304 EAST WEBER AVENUE,THIRD FLOOR � � <br /> STOCKTON CA 95202 <br /> (200)468-3420 AUG 2 9 2002 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> eel E I. <br /> APPLICANT_ 1U�t� 4`� /'+ BUSINESS/AGENCY_ �T. PERMIT/SERVICES <br /> AODRESS I L �'� - �G.�w► ' , E.J�V'< < 5.1:l-c_ 'C�5 PA 71371 <br /> • <br /> FACSIMILE <br /> TENTATt V E•APPOINTMENT DATI"c <br /> (Plcasa givo 7 to business da s froin to of applieallon submittal) <br /> ED _�1, <br /> CHECK BOX TO,EXPEDITE REQUEST-387.0940 5T PRO SSED IN 7 BUSINESS BAYS - <br /> SIGNATURE OF APPLICANT ��� 0!.1 � DATE `S 7,V d_t- <br /> FILL_ADDRLSS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> 13 V,4.,� gc�d S�4tK�� <br /> vo <br /> Z ZS-OL <br /> z� W . <br /> �- <br /> 2Pit kio% yr�bo�►t'C 1 <br /> ,JACI�Q,Q W. W a\w.1V vt c01., 4ZLEA <br /> Si 9 I <br /> .J <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) CIHOUSING A13ATEMENT ❑ SOLID WASTE FACILITY <br /> �1 OTHER CLEANUP SITZ;(NON-LOP) O FOOD FACILITY O SOLID WASTE VEHICLE <br /> O UNDERGROUND TANK(MONITORINGJREMOVAL) t7 DOG KENNEL ❑ DAIRY <br /> 0 HAZARDOUS WASTE GENERATOR O CHICKEN RANCH O PKG TREATMENT PLANT <br /> 0 TIERED PERMITT D FACILITY ❑ MOTELIHOTEL ❑ PUMPER TRUCKlYARDlCHEMTOILETS <br /> ❑ TATTOOIBODY PIhIRCING ❑ POOLISPA "` ❑ LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTI!FACILITY 0 PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ADOVE) <br /> 1. List up to ton addresses in the space above. Select the type(s)of files from the list above by chocking <br /> ttic appropriate box(os). 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 file 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 EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a$87.00 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 /> REVIEWED YES NO REVIEW DATE <br /> LH 00 14 GAMYIQG - <br />