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Oct):4-4 03 05: 12p <br /> P. 1 <br /> SAN JOAQUIN COUNTY tHU LUI:NUMULR <br /> OCT 152003 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> IH i'livi i Hr-ALTH STOCKTON CA 95202 <br /> (209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT �G��G� vT �11jCQ�, 11 BUSINESS/AGENCY_j_�_ r(�C <br /> ADDRESS <br /> PHONE ( �� S�� —4 y 3 FACSIMILE <br /> TENTATIVE'APPOINTMENT DATE TIME <br /> (Please 91ve 7 to 10 bucinecs days dadate of aPPII-Ilon submiltat) a <br /> CHECK BOX TO EXPEDITE REQUEST-S89.00 FEE--REQUEST PROCESSED IN J BUSINESS D <br /> .� AYS <br /> SIGNATURE OF APPLICANT DATE iy <br /> FILE ADDRESS THIS 516E EHD STAFF USE ONLY <br /> i PROGRAM ELEMENTS SEARCH <br /> C� <br /> 7 <br /> ENVIRONMENTAL HEALTH DIVISION FILES �n tl / U <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) D HOUSING ABATEMENT O SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) 13 FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) 0 DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR O CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> O TIERED PERMITTED FACILITY D MOTEUHOTEL ❑ PUMPER TRUCKUYARD/CHEM TOILETS <br /> ❑ TATTOOMODY PEIRCING O POOU9PA d LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑ OTHER(PLEASE SPECIFY) <br /> 1. List Up to ten addresses in the space above. Select the type($)of fifes from tho list above by Checking <br /> the appropriate bax(es). At least one file type MUST be selected. Fqx to (209)464-4138 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 END 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 expanse <br /> of the applicant. Future file reviews by the same applicant may require a$89.00 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 /> END 46.02•006 <br />