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07/02/200210:28 FAX . W 001�y <br /> CATS IMCOM <br /> Aft <br /> .. <br /> AF aUSAN J ',. <br /> UIN COUNTYPUDLIC HEALTH S IGES %a¢Nvi <br /> ENVIRONMENTAL HEALTH DIVISION <br /> " 304 EAST WESER AVENUE,THiRD FLOOR <br /> Z6 STOCKTON CA 95202 <br /> ? (209)468.3420 <br /> D'1. ,!'U PUBLIC RECORDS RELEASE APPLICATION <br /> r81 •• ' q. <br /> APPLICANT�IJ AN BE ^AR BUSINESSIAGENCY VIA Q11ft-(A4VdT'A1-~ <br /> On <br /> 9•( <br /> �' CIN► d sy`Trt�rs /..rc. <br /> ADDRESS -416:1 //�D p b,-ow Svlsr ,O �ilW646 amImm Cit law t. <br /> PHONE FACSIMILE <br /> TENTATIVE"APPOINTMENT DATE �-Y Ib , TIME 4:60 af4 <br /> (Please glue 7 10 USl srd da pplicat" sub mittal) <br /> CHECK BpX TO ExPEDITE RHQU T-$89.00 —RE CE$55D 1 8U ESS DAYS <br /> SIGNATURE OF APPLICANT �"' - DATE v <br /> .r <br /> PILE ADDRESS THIS S1012 END STAFF: $ANLY <br /> PROGRAM ELEMENT 'bCARCH <br /> (3 .3 a We5T 4 M*C0- We fill; <br /> 4a ds <br /> 64 star, I <br /> a06 Sf.,j j"M CA 5YA-TIZ7 l l l R a = <br /> aa-*5 e✓. c CA njL"0I 0144 - <br /> Awo <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> Al. <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 13HOUSING ABATEMENT ❑ SOLID WASTE FjK(LTIY <br /> ❑ OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY C1 SOLID WASTE V01ftt <br /> Gr UNDERGROUND TANK(MONrrORINGIREMOVAL) ❑ DOG KENNEL L DAIRY i <br /> 13 AZARDOUS WASTE GENERATOR C3 CHICKEN RANCH 13PKG TREATMENT• � T ' . <br /> Cl'TiEREP PERMrrTED FACILITY 0 MOTWHOTEL ❑ PUMPMR TRUCK)II00pICHEM TOiLWM <br /> O TATTOOIBODY PORCING E3 POOLISPA ❑ LAND USE APDL4�FION SrMS <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM 0 OTHER(PLEASE 96,tCIFY ABOVE) <br /> 1. List up to ten addresses In the space above. Select the type(s)of files from the list0obi by checking <br /> the appropriate box(es). At least one file type MUST be selected. fax to (2091464- or mail to the <br /> address Indicated above. <br /> 2. EHD will notify the applicant if any END flies exist. An appointment for review will t7ti Conflrmed <br /> approximately five business days but no later than ten (10)days after receipt of ap oft,kion. The files <br /> Will be held for a maximum of five business days for review. Appointments should ideheduled <br /> accordingly. r.{ <br /> 31. A file that is actively being worked on by EHD staff may not be immediately availabi`..` r 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'ikaff at the expense <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 p' -- <br /> DATE CONFIRMED _ PHONE FAX iNITIALS ,� <br /> M. <br /> REVIEWED YES NO REVIEW DATE <br /> Ar <br />