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W6926.341 <br /> _$-18-2000 09:169M FROM TQ P.02 <br /> kG>rlYt;t7 UID I uu NU4iUktt <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> .ENVIRONMENTAL HEALTH DIVISION /�- <br /> 304 EAST WESER AVENUE,THIRD FLOOR ` <br /> STOCK ON CA 95202 <br /> (209)46".420 <br /> _ PUBLIC RECORDS RELEASEE APPLICATION �� 1 <br /> ppP1.ICANT ,2.N yV�at�✓S-3 BtSs[NESSJAGENCY ,1-�C �C���tJrV <br /> PHONE `. <br /> TENITATiVE*APPOINTMENT DATE TSE v �m <br /> (Please give 7 to 10 -nes days frogs date of application subin!=) y� T <br /> u CHECK BOX TO EXPEDITE REQUT;S�$7 FEE—REQUEST�PIROLCEESI�480IN3 BUS{NESS DAYSSIGNIATt1REOFAPPLICANT + �.� ® ) DATE C �a <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAMA ELEMENTS SF-ARCI4 <br /> • <br /> Ale <br /> I 1 <br /> ENVIRONMENTAL HEALTH DIVtS10N FtLESISM <br /> UNDF-RGROUNID TANK(UST)CLEANUP SFIE(LOP) 0 HOUSING AFIATEMENTT 0 SOUP WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) [7 FOOD FACILITY 0 SOUR WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORI WREMOVAL) M DOG KENNEL D DAIRY MAY 25 L''Ju <br /> tiAZARVOUS WASTE GENERATOR 13 CHICKEN RANCH D PKG TREATMENT PLANT <br /> TIERED PERMITTED FACILITY t O MOTQIHOTEL O PUMPER T9UCICIYARVECttENTaLETS <br /> O TATTOOJBODY PEIRCING a POOLISPA 0 LAND USE APPurATION srrES <br /> O MEDICALWASTE FACILITY d PUBLIC WATER SYSTEM 0 OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses in the space above. Select the type(s)of(ties from the list above by checking <br /> the appropriate box(es). At least one file type MIDST be selected. Fax to('208)464-0138 or mail to the <br /> address indicated a ve- <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$78.00 deposit prior to review. l <br /> 5. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm wilt be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> RF- <br /> VIEWE.D YES NO REVIEW DATE <br /> Erc oe,. <br /> TOTAL P.02 <br />