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11-14-2141'l" u. ix''Ju_ 1 I'.ci.i <br /> ENO wo HUMM4 <br /> j SAN Jr UIN COUNTYPUBLIC HEALTH VICES <br /> ENVIRONMENTAL HEALTH DIVISION T_(_� <br /> 304 EAST WEBER AVENUE,THIRD FLOOR Lf <br /> STOCKTON CA 95202 <br /> (209)468.3420 <br /> POBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT _ r C j a Q IIUSINE-%SIAGENCY We-d-1 k se A .1.1 o cr_ L <br /> ADDRESS 3 o /Sb A . j <br /> PHONE 4Pj — FACSIMILE j �I7 / 7 oc— <br /> TENTATIVE*APPQINTMENT DATE TIME E� r° <br /> pfrom date give 7 to 10 businass days frodate of application submittal) III 2 2On1 <br /> GlvirS �, � L 2 L_ VJ <br /> CHECK BOX TO EXRaPfff;REQUEST-X87.00 FEE—REQU . Y PROCESSED IN 313UUENESS DAYS <br /> SIGNATURE OF APPLICANT DATE, to 6` <br /> FILE ADDRESS TH13 <br /> SIDE END STAFF USE <br /> Y <br /> PRQGR AM ELEMENTS SEARCH O <br /> o n.. q t 3 3e g,-_-0, Z .Zza <br /> o v II c 3 90PO z3 z z O <br /> 2 40 �z Y3�o 0 80 <br /> a q {,J S _ S 8/, 5-.06 Lq <br /> ENVIRONMENTAL HEALTH DIVISION FILES JUN 26 2001 <br /> NDEROROU'D TAAIK(UST)CLEANUP SITE{LOP) ❑ HOUSING ABATEMENT E] SOLID WASTE vACiLrry <br /> rU <br /> THER CLEANUP SITE(NONE OP) ❑ FOOD FACILITY L1 SOLOWASTE VEHICLE <br /> NDERGROUNDTANK(MONITQIZINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> AZARDOUS Vi SITE <br /> GENEEiATOR ❑ CHICKEN RANC-K ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY Q MOTELniOTEL Cl PUMPER TRUCKIYARDICHEM TOILETS <br /> 0 TATT00160DY PEIRCiNG m POpUSPA C1 LANP USE APPUGATION S17Es <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ QTHLH(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addrs sses In the space above. Select the types)of files from the list above by checking <br /> the appropriate bax(es). At least one file type MUST be selected. FAX to (209)4§4 g1D.1 mail to the <br /> address indicated above. <br /> 2. EHD will notify the appilcant If any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than tan (10)days after receipt of application.-The files <br /> will be held for a maximum of five business days for review. 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 now <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. FI.Iture file reviews by the game applicant may require a$3'T-W depCsit prior to review. <br /> �• 'TENTATIVE appointment dates roust be confirmed With I;HD Staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT 13ATE TIME <br /> DATE CONFIRPAED PHONE- FAX; INITIALS <br /> REVIEWED YES NQ REVIEW GATE <br /> n' a is o rca <br /> TOTAL P.01 <br />