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SAN JC - WIN COUNTYPUBLIC HEALTH SER' CS —4VIRONMENTA4 HEALTH DIVISION 304 EAST WEBFR AVENUE, THIRD FLOOR (Q STOCKTON CA 95202 (209) 3683420 PUBLIC RECORDS RELEASE APPLICATION APP11CAtfT N,ut.(iL�L- ��Qtt76'1� 6USINE551AGENGY �gN4o ��y{(e oLA (716 �' ` A0DRESS_J.5$ fpA-NK W✓:'ST CtRr�iS Svt'tE.1, S1-0CK%N PHORE 2-3y" -0SJ Si FACSIMILE Z�'f X538 l• TENTATIVE" APPOINTMENT DATE TIME (Please y1V e 7 W IV V W1caas �OJars hom data of application submItW ) U/-// T5 oC 3.1 Q CHECK BOX T7 rAPF-DITE REQVE4T•;47,0 FEE- REQUEST PROCEg9 OeIa BLLSWlSS DAYS Or�-r n SIGNATURE OF APPLICANT DATE o/ 8 0 OCT 1 J ENVIRONMENTAL HEALTH DIVISION FILES O ONDEROROUND TANK (UST) CLEANUP SITE (LOP) d HOUSING ABATEMENT XSOL1DWA5TEFACIUTY JAf OTHER CLEANUP SITE (NON -LOP) 0 FOOD FACILITY t7 $000 WASTE VEHICLE JS UNDERGROUND TANK(NONITOKINGfKEMOYAL) t7 DOr'KENNEL PCDAJRY JC HAZARDOUS WASTE OCNt BATOR itGKx;KEN RANCH O PKG TRFATMENTP(ANT 13 TIERED PERMITTED FACILITY U 1-fHOTEL D PUMPERTRUCKMARDICHEMTOILETS ❑ YA7TO0/B0DY PMCeau 4 POO"J'A - O LAND USE APPLICATION SITES PILMEDICAL WASTE FACILITY O PUBLIC WATERSYS EM Cl OTHER (?LEASE SPECIFY ABOVE) 1, List up to ten addresses In the space above, Seloot the typ*(s) of Thea from the Ust above by [necking the appropriate box(es). At least one fit* type MIDST be salaQted. Fax to (2091 d64.Ory3ttr mail o the address lnoicated,WUL)e. 2' EHD will notify the applicant if any EHD filea exist. An appointment for review will be Confirmed approximately five busln ess days but no later than ten (10) days after receipt of application. The files Will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. 3. A file that is actively being worked on by EHD Staff may net be immediately available for review. A new application may be Submitted when the file Is avaliabie, 4. Any file mot returned in the same condition as released Will be reorganized by EHD ateff at the expense Of the applicant. Future file reviews by the Same applicant may require a SH7.00 deposit prior to faview. 5. 'TENTATIVE appointment dales must be COAftrmad with EHD staff, 6. Ap(Zlicatlons received atter 3:40 pm will be processed the next business day, CONFIRMED APPOINTMENT DATE TIME DATE CONFIRNIED Pl10NE FAX INITIALS REVIEWED YES NC)RMEW DATE _ TOTAL P.32 a. _ `a, tie• , INN ENVIRONMENTAL HEALTH DIVISION FILES O ONDEROROUND TANK (UST) CLEANUP SITE (LOP) d HOUSING ABATEMENT XSOL1DWA5TEFACIUTY JAf OTHER CLEANUP SITE (NON -LOP) 0 FOOD FACILITY t7 $000 WASTE VEHICLE JS UNDERGROUND TANK(NONITOKINGfKEMOYAL) t7 DOr'KENNEL PCDAJRY JC HAZARDOUS WASTE OCNt BATOR itGKx;KEN RANCH O PKG TRFATMENTP(ANT 13 TIERED PERMITTED FACILITY U 1-fHOTEL D PUMPERTRUCKMARDICHEMTOILETS ❑ YA7TO0/B0DY PMCeau 4 POO"J'A - O LAND USE APPLICATION SITES PILMEDICAL WASTE FACILITY O PUBLIC WATERSYS EM Cl OTHER (?LEASE SPECIFY ABOVE) 1, List up to ten addresses In the space above, Seloot the typ*(s) of Thea from the Ust above by [necking the appropriate box(es). At least one fit* type MIDST be salaQted. Fax to (2091 d64.Ory3ttr mail o the address lnoicated,WUL)e. 2' EHD will notify the applicant if any EHD filea exist. An appointment for review will be Confirmed approximately five busln ess days but no later than ten (10) days after receipt of application. The files Will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. 3. A file that is actively being worked on by EHD Staff may net be immediately available for review. A new application may be Submitted when the file Is avaliabie, 4. Any file mot returned in the same condition as released Will be reorganized by EHD ateff at the expense Of the applicant. Future file reviews by the Same applicant may require a SH7.00 deposit prior to faview. 5. 'TENTATIVE appointment dales must be COAftrmad with EHD staff, 6. Ap(Zlicatlons received atter 3:40 pm will be processed the next business day, CONFIRMED APPOINTMENT DATE TIME DATE CONFIRNIED Pl10NE FAX INITIALS REVIEWED YES NC)RMEW DATE _ TOTAL P.32