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r- <br /> Z <br /> .,,. L,1....n JOAQUIN COUNTYPUBL'IC HEALTH SERVIC40w <br /> / ENVIRONMENTAL HEALTH DIVISION <br /> +' <br /> id. '!k 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCK'TON CA 95202 <br /> 468-3420 <br /> 02 JU;:} I 0 AKI0; WBLIC RECORDS(209)- RELEASE APPLICAtION ` <br /> APPLICANT Me BUSINESSIAGENCY <br /> AbORESS�f e-3 <br /> PKOHE _1 " ! q FACSIMILE 5 10 <br /> TENTATIVIr`APPOINTMENT DATE �r TIME _ <br /> (Please give to O�sin im dal r appTI an sutamlttal) <br /> Wd <br /> CHECK BOX TO EXPEDITE RI+ E T-$89. 0 REQUEST PRaCE�I StNESS DAYS <br /> -SIGNATURE OF APPLICANT DATE 8 I S Dti <br /> FILE ADDRIZS5 THIS SIDE ZHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> 1 <br /> 2Q <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> rte.UNDERGROUND TANK(UST)CLEANUP SrM(LOP) O HOUSING ABATEMENT d SOLID WASTE FACILITY <br /> O OTHER CLEANUP SITE(NON-LOP) M FOOD FACILnY 13 SOLID WASTE VEHICLE <br /> 0 N>SFJi111111 TANK(HlON1TORFNWREMOVAI.) O 1304 KENNEL O DAIRY <br /> AZAR)OUs WAST-a <br /> GENER4TGR CHICIife!RANCH ❑ PKG TREATMENT PLANT <br /> d TI6ftI20 pERMRAED FACILITY d IY1dTEtJHOTEL- t3 PUMPER TRuctt;IYARUIC$QM TOILETS <br /> 0 YATTOOISODY PEIRCING O POOLISPA Cl LAND USE APPLICATION SrrEs <br /> d McOICAL WASTE FACILITY 0 PUBLIC WATER SYSTW 0 GTHFR(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above. Select the We(s)Of files from the list above by checking <br /> the appropriate bOX(eS). At least one file type MUST be selected. Fax to[209?464-0138 or mail to the <br /> address i dicated 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 ton(10)days atter receipt of application. The fifes <br /> will be held for a maximurn of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is aativelyr being worked on by EHO staff may not be immediately availabla for review. A new <br /> application may be somitted when the file is available. <br /> 4. Any file not returned In the$acme bondttion a$released will be raorganizOd by EHD staff at the expense <br /> of the applicant. Future file reviews by the same-applicant may require a$89.00 deposit prior to review. <br /> S. 'TIENTATIVE appointment dates must be confirmed with SHO staff. <br /> s. 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 YE=S r NO REVIEW DAVE 4W <br /> saatiaoa • ' <br /> •cnoon +.r.�= .NZI b£:0T Z00Z eT N r <br /> Z020'd t3>=T0b9b69ZT 01 <br />