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DATE <br />FROM : Geo-Phase Env I. riDrinenta I I FA. NO. : 209:1,69029S <br />Lt:u LOG Numilti; <br />/ <br />JAC-C.4. 4ECK BOx -ro EXPEDITE REQUEST - wa_ao FEE - REQUEST PRoCESSED IN BUS1N S DAYS <br />SIGNATURE OF APPLICA <br />AoDREssf-A913 7 lieu e 41. a -7 4(8 - <br />PHONE 5-4.- 9 at ,a________--- FACSIMILE sii-C,F <br />TENTATIVE' APPOINTIANT DATE T i a _ 7742.0 TIME lid <br />(Please give 7 to ID business days from date of dp ['cation ubmitta1) <br />(_,? AI/ 75 <br />i <br />SAN JOA‘,. —of COUNTYPUBL1C HEALTH SER\i• _S <br />ENVIRONMENTAL HEALTH DIVISION <br />304 EAST WEBER AVENUE, THIRD FLOOR <br />STOCKTON CA 95202 <br />. Db lA (209) 468-3420 <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT .7)-e-. la .144 a BUS[NESSIAGENCY 4/6144P-5- 7'01 <br /> <br />vecl <br /> 7----2r.)01 <br />FILE ADDRESS <br />1 /7 s---e- __ 1. <br />CPA Lt <br />.--T-r- I ttli rh ILL7// ..: " •-, ( Aeca <br />SEP 20 2001 <br /> 1 <br />ENVIRONMENTAL HEALTH DIVISION FILES <br />NDER.GROUND TANK (UST) CLEANUP SITE (LOP) <br />OTHER CLEANUP SITE (NON-LOP) <br />D ERG ROUND TANK (MONtTORING/REMOVAL) <br />HAZARDOUS WASTE GENERATOR <br />TIERED pEsmirrco rAC1LITY <br />TATTOO/BODY PEIRCING <br />MEDICAL WASTE FACLUTY <br />0 HOUSING ABATEMENT 0 SOLID WASTE FACILIT( <br />0 FOOD FACILITY 0 SOUD WASTE VEHICLE <br />0 DOG KENNEL 0 DAIRY <br />0 CHICKEN RANCH o PKG TREATMENT PLANT <br />0 MOTEL/HOTEL 0 PUMPER TRuCtvYARD/CHEM ToILET5 <br />0 POOUSPA 0 LAND USE APPUCATION saes <br />0 PUBLIC WATER SYSTEM El OTHER (PLEASE SPECIFY ABOVE) <br />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 ta1209) 464-0138 or m?il to the <br />address indicated above. <br />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 />A file that is actively being worked on by El-ID staff may not be immediately available for review. A new <br />application may be submitted when the file is available. <br />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 978.00 deposit prior to review. <br />S. *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 /> <br />REVIEWED YES NO REVIEW DATE <br />EH 00 -14 — voliap