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rI.0"I Ground Ler i+rjl4eas W-li.fit tij. zb-r U.iJ '_%dL'_. t -dui <br /> SA JOAQUIN COUNTYPUBLIC HEALTH 5ERVICES eiw w,"N"" <br /> ENVIRONMENTAL HEALTH DIVISION <br /> �i !i J -� i�i 304 EAST WEBER AVENUF,THIRD FLOOR <br /> IIIYYY srpcKTON CA 952o2N <br /> (239)460.3420 <br /> 1 5 PUBLIC RECORDS RELEASEE APPLICATION <br /> APPUGANT �lO�w.. V\.Q, UUSINESS/AGENCY <br /> ADDRESS 714 5c+v,-R.j-- c75,cg10n ( A 't S-3 <br /> TENTATIYE'APPOINTMEN'rDATE I� a 6I TIME <br /> {Pians.eiw 7lta lo�br:/ai.eue days f�rv!- dety of�Opticatipy a�jrglR,j!) <br /> G}IEGK SOX 70 EXpEO.iE � � <br /> RE4U66i-f7B.00 F^eE/gUpRJbJg9 �IN <br /> 7 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ��•� � DATE Cd l D <br /> FtLa ADDRESS THIS SIDE M4U TAFF USE ONLY <br /> —?;Tb rJ <br /> PROGRAM ELEMENTS SEARCH <br /> _ <br /> W El <br /> 7 t 1 La n <br /> r <br /> I <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK fus.9"ZANUPSITe(Lop) ❑ HOVSaxG ABATEMENT 3 SOUO WASTE FACILMY <br /> OTHER CLEANUP SIT=UNOAIOP) Z1 FOOD FACILITY v SOLD WASTE VEHICLE <br /> UND=-R'7ROJRD TANK;tAONROR'UG1RF.MOVAL) U DOG KE9N9L Cl. PA{RY <br /> HAZARDOUS WASTE GENERATOR 0 CHICKF9i ANC4 ❑ PKC TRCATMENT PLANT <br /> U TIERED PERM;T EEo=ACILn-y G MOTELNOT`L ❑ PUM?ER TTLUCKITAku1CNF7d T09,hTS <br /> C TATTOOIBODY PaInCUiG a POOLI$PA LAND USE APPLICATION SITES <br /> MEDICAL IYASTL rACL1TY .7 PUBLIC WATER SYSTEM OTHER(PLEASE 3PEC&Y ABOVE] <br /> t. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking <br /> the appropriate bo%(es). At least one Sae type MUST be seieated. F x "+o 464 or mail to the <br /> pddrgis indicated above <br /> 2 EHD wiU notify the applicant if any EHD fl!es exist An appointment for review will be confirmed <br /> approximately five business day$but no later than ten It 0)days after receipt of application. The files <br /> will be held for a maximum of five bUslltess days for review. APP01111 rents should he scheduled <br /> accordingly, <br /> J. A file that Is aarflvaly being worxed on by EHD staff may not be immediately available for review_ A MW <br /> applicytion may be submitted when the file is available. <br /> 4. Any file not retumed In the same condition as released Will be reorganized by EHD staff at the expense <br /> Of the applicant Future file reviews by the sante applicant may require a$78,00 deposit prior to review, <br /> 5. 'TENTATIVE appo)n--hent dates must be confirmed with EHD staff, <br /> 6. Applications received after:);0o pm wX be processed the next business day. <br /> CONFIRMED APPOIRTPAENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REyIEWED YES NO REVIEW DATE <br /> 70TAL P.01 <br />