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82/13/2083 15:69 464613E U E�lIRa4ww& HEALTH PAGE 02 <br /> JOAQUIN COUNWPUBLIC HEALTH SERVICES <br /> ENVIRONMIENTALHEALTH DIVISION r <br /> FEB 1 3 2003 304 EAST WEDER ralVENur-,TH1110 FLOOR +^7 <br /> STOCKTON CA 55202 ✓ <br /> (209)408.342D <br /> :. F,';El"VICOURLIC RECORDS RELEASE•APPLICATION <br /> . .. a <br /> APPI.ICJWT rL tJ r`7^�� (L RUSINESWAORKY ` t` G 1�G�OQ tvC' <br /> Ic ADpRI��J3 ^�y�`"IOgcLta A aS�1+ '1 ti' z <br /> 1C PHON4� RZ�r U4' FAa$riYiilE ~'d{� p <br /> T>ENTATIV)~"APPOINTMt-NT UAYI3 2 d Ttme 1: <br /> mcame alvo T 1Q ve bu*13 a d Iro from date of oppllead-aabm11121k ` y <br /> ICGIt - u / <br /> CI 110X Tli Ek(PL•orrt:(it=4UEST-;tti9.pa F R PktOCES8E01N�gU81NEs3 <br /> *-SIGNATURE OF pF ApF'UI:ANt DATI _' CZ <br /> 1- 97 V <br /> rILE AC RX-93 THIS 940E ENO STAFF USE ONLY <br /> PROGRAM E1.12-11IENTS 5EARCH <br /> 5 N <br /> 4=k- <br /> -3-7 <br /> ENVIRONMENTAL.HEALTH DIVISION FILES <br /> i1J UH0ERGROUND TANk(USTf CLeANUP SITE(L6P) a HOUSING ABATEMENT 1/601.10 WAST13 FAG11ITY <br /> L7 OTHER CLEANUP SM 04ON-LOP) 1, 0 FOOD FACILITY ❑ SOLID WASTP VENIC1_F <br /> .� i513 HOERC#f101.NO YANK(IkONITORINGIREMOVAL) 13 WG KENNM o DAIRY <br /> e"1 :ARt]OUS WAS TIE 0ENGRAT0.R d CHICKEN RANCH a toKti TRI.ATmFNT PLANT <br /> 0 T161tGG PERM=VO FACILITY 0 MOTE IN01t:(. 0 PUMPVR T'RUCK/YAagICISEM VOILETB <br /> ❑ T'AT OOMODY PERCINO 0 POOUSPA 17 t,ANO USC APPLICATION SITE$ <br /> n rNlEillCAl.WASTE FACItt1Y 0 0-MER(PLILA51:SPECIFY ABOV41 <br /> 1_ List up to ton nddresses In the Spaca above. Select the type(&)of files from the list above by checking <br /> the appropriate box(ax). At least ane file typo MUST be selected. Fa -01 B or mail to the <br /> iiddE2ss In .3 tttd I)OVe <br /> 2 EMD will notify the applicant if any END rites exist. An alppdintment for ravlow will bo confirmed <br /> approximately We business days but no lator than ton(10)days after receipt or application. The files <br /> will be hold for a maximum of five business days for review, Appointn fonts should be schcdvTod <br /> accordingly. <br /> 3. A file thatJn activelylbtting worked on by EHO staff may not be Immediately avaiImblo for review. Anew <br /> application miuy be-submitted when tho Elle is Available. <br /> 4. Any file not rettirned l(1 the same condition as reloatsod will bti reorganized by END staff a r flr s.s ;74 <br /> 7 <br /> of the applicant_ Futuro File reviews by the same applicant may require o ;199.00 dtrposit yor�a:r�vTe �;��.' <br /> 5. ITENTATIV> appointment dstos must bo conflrmod with END 1s;taff.. ' <br /> ii. Applications recopied after 3144 pm will bo procosscd the next business day. <br /> CONFIRMED APPOINTMENT BATE. TIME _-- <br /> DATE CONFIRMED PHONti FAX INITIALS <br /> REVIEWED YES NO . REVIEW DATE ^ ' <br />