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7 <br />r <br />PI -IF -INE 209 369 4228 _ Feb. 09 2000 09:08PM P2 <br />Lal ;:J _.=a�,� c•%Jl <br />SAN .:.,,AOUIN COUNTYPUI3"r Hr:AI_TH <br />ENVIRONMENTAL HEALTH DIVISION�ViCf=5 <br />304 FAST WEBER AVENUE. THIRD FLOOR <br />STOCKTON CA SM202 <br />(.209) 40-3420 <br />PUBLIC RECORDS RELEASE APPLICATION <br />Av t.1t"iknT 1 1n QY{� 1 Y l • (�.s'LY eustx�ssrAUmY�'�� �• t�s' Y�/k'�-,m� � <br />P1i0N6 - FAMmaz <br />TENTATIVE' APFLaXTNtENT CAT& nr4E <br />(A142- give 7 to 10 0u Unssa days!,,, aals of appSk4egN aubrrJttai) <br />Ciit;CK 80X TO EXRCDIT! REQUEST� -�4t��,4, o F�� _ �,gi1FST pROCESSFA 1N 3 t34113WF�8 DAYS <br />SIGNATURE OF APPLICANT _ Yc {�}� mak- � (� � DATE � } <br />ENVIRONMENTAL HEALTH DTVI$ 0.4 FILES <br />*UNaERGROUMb TANK (UST) LLWANUP girt (LOP) O 4OU5INCABATEMENT In SOLID WASTE FACIUTT <br />❑ OTHER CLEANUP am (NON -LOP) O WOOD FAI:11J" b SOLID %*40. `rE VMCL: <br />URQURGROUM TAMK iHOMTOfLtN01R'F�NOVA]? ❑ DOG KENML Q DAIRY <br />;<hALAP00U4 VrAWM GW,FP:ATOR ❑ Ci X*EN RAXCH CS PKK TFWATMIDIT PLANT <br />C 'n9REn PCIFIXITTED FAS; -Y i3 MOTEUHOM ❑ PUMPER TRUCK/YARa+CHEM YCILETS <br />II TA7TOOWDY PGGtNG 13 POOLMPA Q LAMS USE APPLICAMON SITES <br />❑ VLQ1QAI-WA$TC FACILITY D PUI&LSC WATER SYSTEM 13 OTHER (P "A15 SPECTY ABOVL') <br />i • Ust Up to tun aiddrowks in the spaces above. Select the type(s) of files from ttie list above by chackino <br />the appropriate box(os)_ At 1ea6t onu file type MUST be selected. Ejuto (109) 464-0135 Qr mIH to the <br />naalalrk inAk. ted alagm <br />2. E14D will notny the applicant if any EHO files exist. An appointment for review will ba confirmed <br />approxtmately five buslnosa dayt but no Satter than ten (10) flays after reccipt of application. Tete iilas <br />will bo hold for a max"unurn Of fire bu3inoss Clays fOr tavfaW. Appolr t>tortts should be scheduled <br />accorxiingiy. <br />3. A rile that is actively being worked on by EHE2 at$ff may not ba tr=e6aWy av®ABble Tor mviaw. A new <br />application may be submitted when the Ilia is available. <br />4. Any fife hot returned in the came uandl6on es rtleasad "I be reorWritzea by EHD staff at the expense <br />Of the epplir-Ant. Futurs file reviews by" CXMG applicant may require a $70.00 deposit prier to vnvlew_ <br />S. 'TEIRTATIVE appointment dates must tae confirmed with EHO stntf. <br />G. ApplicaV*ns receN-ed afttr 3:00 pm will be processed the next buMneas day. <br />CONFIRMED APpowTMENT DATE TIME <br />DAi E CONFIRMED <br />P140HE FAX IP4MALt; <br />1 - <br />R1;VICYlEb YES NO REVIM OAYE <br />14 o w <br />TOr;SLL ?,21 <br />