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Mar • 5. 2002 5 :07PM �`IOR EARTH TECHNOLOGIES No 8600 P. •4/4 <br /> SAN .lOAG2UlN t;OUNTYpU6L1C HEALTH SERVICES rlwLocnuraeEn <br /> �J <br /> 11 ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WESER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 1 'woof <br /> POAR -5 Frl ii- O - (209)468-3420 7 <br /> PUBLIC RECORDS RELEASE APPLICATIO <br /> N <br /> APPLICANT�Q 4 per Y E�BUSINF3a)AGENC,rY�( <br /> ADDRESS 1VV r � ��+y <br /> PHONE FACSIMILE G- 34 <br /> '[ <br /> TENTATIVE'APPOINTMENT DATE i' tr/`,'k02:'� TIME U I' m . <br /> (Pitraso wo to to buauuss date atappiit iw n sCA <br /> ) <br /> 0 .CHECK 60X TO EXPEDITE REQUEST 0 FIi����H <br /> SIGNATURE OF APPI-.idANT + DATE U 2 <br /> it 1 <br /> FILE ADDRESS I THIS SIDE EHD STAFF USE ONLY <br /> it PROGRAM ELEMENTS SEARCH <br /> 36:2Z _ <br /> t1 U 'I <br /> I a <br /> o - 3SzT <br /> I4H AsomwC.. <br /> i / � 2yFo' 95D JI'.I <br /> t <br /> 'f <br /> I ENVIRONMENTAL HEALTH DIVISION FILES <br /> Er UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT r,'l SOLID WASTE FACILITY <br /> 0 OTHER CLEANUP SITE(NON-LOP) 0 FOOD FAcILITY ❑ $OLID WASTE VEHICLE <br /> t1'uNDERGROUNO TANK(MONITORING/REMOVAL) ❑ 1300 KENNET. DAIRY _ <br /> M3'HAZARDOUS WASTE GENERATOR R-CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> L9-TIERE13 PERMITTED FACILITY 17 MOTF_LIHOTEL 'l 4 PUMPER TRUCKJYARD)CHEM TOILETS <br /> ❑ TATTOOMODYPEIRCING 0 POOUSPA ❑ LAND USE APPLICATION SITES - <br /> M-MFOICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM it © OTHER(PLEASE SPECIFYAtSOVE) <br /> ;I <br /> 1. List up to ten addresses in the space above. Select the typq(s) of files from the list above by checking <br /> the appropriate box(ez). At least one file type MUST be selected. Pax to(209)464-01313 ormailto the <br /> address indicated above. i( <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. II, <br /> 4. Any file not returned in the same condition as released will tie reorganized by EHD 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 /> CONFIRMED APPOINTMENT DATE TIME <br /> j DATE CONFIRMED PHONE FAX INITIALS <br />