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SAN .iVKQUIN COUNTYPUBLIC HEALTH SP!OVICES <br /> ��t / ENVIRONMENTAL HEALTH DIVISION <br /> 0• 7 t 304 EAST WEEDER AVENUE,TURD FLOOR <br /> STOCKTON CA 95202 <br /> (209)468.3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT�-�,� , J f 6USINESS!AGENC/Y �] <br /> ADDRESS 1T _.�? - Ott-k F .ly�/'T'Y�"L1 S- I•A__ JL in&"v <br /> Phoria ��" `�.2.� 7/oyf FACSIMILE • 121✓ V ��7��•�t�� <br /> TENT AfiV E"APPOINTM_NT OAT= / 1LLC.Gf al O� TIMI <br /> (?laaza Dive T la mD�ce�a�m aam u'aFPlicaliun sJSmiitai} � <br /> CHECK BOX TO EXPEDITE REOU_5:•SZ-,,PC,t 6E-REQUEST JC�Eyt/a IN/3 BU51NFSS OA:'5 <br /> ' (d'L/�1 <br /> SIGNATURE OPi+r'Pi_ICAVT ' DATE <br /> �— Flt E ADDREFS THIS SIDE EHO STAFF USE ONLY <br /> PROGRAM LLEMLNTS SEARCH <br /> LIT-: <br /> LLl_j,2F_/Y'6.Al T S7YLFF-T .X38' 't <br /> l <br /> O.� F S .2310/ 3to0._Y � 39 <br /> �.1-iL•__T. rQmoNT 5tQ2 ___2381 `l9 � D <br /> ENVIRONMENTAL IICALTH DIVISION FILES <br /> NDER14RQjNU TANK L1.15Ti CLEANUP SIT,;WYI L HCUSiNG ABATEMENT M SOLIij WASTE FACIUTY M AY 17 2001 <br /> OTHER CLEANUP SITZ(NON-LOP) M FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> JNDERGROU?ED TANK{MONn ORINGIREMMOVALI "- DOG KENNLL - 0 DAIRY <br /> HAZARDOUS WASTE GENERATOR = CHICKEN RANCH O PKG IREAIMENTPLANT <br /> O PERED PER141TrED rACILITY :=1 MOTEL'HOTEL G PUMPER TRUCK;YARDICHEM TOILETS f ' <br /> C Tai,=5ODY PcIRC1.%G O POOLJSPA O LAND USE APPLICATION SRES ,`/(1' <br /> M MEDICAL WASTE FACILITY O PUBLIC WATER SYSTar.; :I OTHER(PLEASE SPECIrYADOYE) <br /> 1. List Up to ten addresses in the space above. Select the type(s) of files from the list above by checking <br /> the appronrate box(es). At!east one file type MUST be selected. Fax.to (209)464.0138 or mail to the w <br /> address indicated above- <br /> 2. EHD will notify the applicant if any EHD Was 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 tiles <br /> will be held for a maximum of Five bUSfness days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that ib actively being worked on by EHD Staff may not be-immediately avdilable for review_ A new <br /> application may be submitted whan the file is aval!able, <br /> 4. Any filo 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$67.00 deposit prior to reviev:. <br /> 6. "TENTATIVE appointment dates must be confirmed with EHD Staff. <br /> S. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME i <br /> DATE CONFIRMED __.._ PHONe FAX {ItitTIgLS <br /> REVIEWED YES NO REVIEW DATE <br /> •R a eevrlw — <br /> T�JTAL. P.E91 <br />