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0/2003 12:40 FAX 209 948x- 1 0002/002 <br /> GATE MWED EM LOU HWMe ER <br /> SAN JOAQUIN COUNTyPUBLIC'HEALTH SERVICES <br /> r t <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 FAST WEBER AVENUE,THIRD FLOOR <br /> 1I 0 <br /> C ' G 200:• $TOCKTON CA 95202 <br /> (209)468-3.420 <br /> PUBLIC RECORDS RELEASE APP <br /> LIGATION <br /> APPLICANT J�l;y l iA -S 1 n fSrug . BUSINESSIAGENCY Lr k <br /> _ CA. <br /> k I , <br /> PHONE �r�lr�I� l"3 5 _ FACSIMILE `4$ O -- <br /> Ik / <br /> TENTAT(VE'APPOINTMENTDATE_ 1 f a f O TIME I�u� <br /> (Please give 7 to 10 business days from date of applicatlon sut3mittal) <br /> r <br /> is <br /> CHECK 80X TO EXPEDITE REQUEST•$47.00 FEE-• EST PROtrE$$ED W a BUSINESSDAYS � <br /> ii DATE o'-S <br /> SIGNATURE U;=APPLICANT - <br /> FILE A00Rr=SS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> k, . <br /> u lis 1ti li ` r <br /> y tc3 i. .kl I' LL <br /> Z6 ir. N• � tr �+ <br /> ih <br /> ENVIRONMENTAL.HEALTH DIVISION FILES <br /> IF UNDERGROUND TANK[11ST]CLEANUP SI M[LOP) Cl HOUSING ABATEMENT f d SOLD WASTE FACIUIY <br /> tp OTHER CLEANUP SITE(NON-.OP) fl FOOD FACKM 0 SOLID WASTE VEHICLE J <br /> tF UNDERGROUND TANK(MONITORINGIR.E;MOVAL) Q 000 KENNEL )01. DAIRY 9 <br /> EI HAZARDOUS WASTE 0F:Nrz9ATOK 0 CHICKEN RANCH PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY A M4TELMOTEL PUMPER TRUCKJYAMCI IEM TOILETS <br /> Cl TATCOOBODY QEIRC[NG il• ❑.POOMPA IR'LAND USE APPLICATION STIES R <br /> c3 MEDICAL WASTE FACti-rIY M PUBLIC WATER SYSTEM OTHER(PLEASE SFECtFY ABOVE) <br /> 1. 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. ax to 204 464-0135 or mail to th8 <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 fire 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 /> a. Any file not returned In the same condition as released will be reorganized-by EH <br /> D staff at the expense <br /> Of the applicant Future file reviews by the same applicant may require a $87.00 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 /> it <br /> CONFIRMED APPOINTMENT DATE TIME.• ! <br /> DATECONFIRMED PHONE FAX INITIALS <br /> i7F=I/1�1A1Fr1 y>= hill oFvl>=w nnTF <br /> If � <br />