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07/11/2003 13: 47 2094671 -4• AGE STUCKIUN PAGE 01/01 <br /> OATS RMOVED t14D Loo <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL.HEALTH DEPARTMENT <br /> Jul- 1 NO 304 EAST WESER AVENUE, THIRD FLOOR L^ <br /> STOCKTON CA 95202 <br /> (209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT ZA y� h � S1NE55lAgENCY �C�� Gee _n JYY}nwonhu <br /> ADDRESS <br /> [ Ij Q Sr�]l g� [ a t <br /> PHONE OS� _%01_ ILS& FACSIMILE a09 <br /> `I <br /> i 10 <br /> TENTATIVE*APPOINTMENT DATE I�ti t) -__ 63 TIME •gyp[/ AnAl <br /> (Please give 7 to 10 businas days from date of application submittal) <br /> CHECK BOX TO EXPEDITE REQU $89.00 FEE-REQ ST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ' DATE <br /> I I <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> [� PRO RAM ELEMENTS SEARCH i <br /> 1 S <br /> W . <br /> a � <br /> wt �� <br /> r>, <br /> � � a <br /> W rN <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK JUST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOUD WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE l <br /> UNDERGROUND TANK JMONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DA1RY J <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY ❑ MOTELIHOTEL ❑ PUMPED TRUCKIYARDICHEM TOILETS <br /> ❑ TATTOOIBODY PEIRCING 0 POOLISPA ❑ LAND USE APPLICATION SITES j <br /> ❑ MEDICAL WASTE FACILITY <br /> 0 OTHER(PLEASE SPECIFY) � <br /> 9. List up to ten addresses in the space above. Select the type(s) of files from the Ilst above by Checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to 209 464-0138 o mail to the <br /> address indicated above. <br /> 2. EHD will notify the applicant if any EHD files exist. An app)aintment for review will be confirmed <br /> approximately five business days but no later than ten(10)days after receipt of applicatlon. The files <br /> will be held for a maximum of five business days for revie i. 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 $89.00 deposit prior to review. <br /> 3. 'TENTATIVE appointment dates must be confirmed with E staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> Sop L5DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EH6 48-0.2-009 <br /> 312612Q03 <br /> I <br /> - I <br />