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01 03( 003 15:16 4140130ENVIRONMENTAL H_ALIH <br /> ,"..k" _ <br /> — <br /> J JO. IUIN GDUNTYPU13LIC HEALTH SERvICES <br /> " " v ENVIRONMENTAL HEALTH DIVISION <br /> 05 <br /> 6 , 304 lZA T V E13ER AVENUE.,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> EN !RO 'j d,A[ 11 f tALi (209) 468-3420 <br /> T, �UBLIC RECORDS RELEASE APPLICATION t1; <br /> PLIC 4 1 N f BUSINESSIAGENCY P C-,: � <br /> DRE s 2 o t-4 10 c D iA L I 7 00 ll ��0 <br /> ONE 2.5 X FA�SIMILE <br /> TENTATIVE*APPOINTMENTDATE AUC'. 2. Co,'200� TIME I : QOnm <br /> IP14450 eive T to 10 buskm ,dayC from date of applirmllon submlUal} <br /> ECK BOX TO Ex DITE REQUEST-$89.ee FEE-REQUEST PROCPSSED Ix 7 BUSINESS DAYS <br /> *S GN URIs OF AP LICA DATE <br /> F14a ADDRESS - THIS SIDE EHD STAFF USe ONLY <br /> PROGRAM ELEMPNTS ScARC (n <br /> Line, o d <br /> GLane F�r <br /> U 14u <br /> r Line 9oaci �V uSr ftw <br /> 3 "b "fir c 3�' U.ST ttw <br /> 7 <br /> � to <br /> 1 <br /> ENVIRONMENTAL HEALTH DMSION 51LES <br /> UN GROUND TA K(UST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> OTH CLEANUPS (NOR-LOP) ❑ FOOD FACILITY O SOLID WASTE VEHICLE <br /> UN GROUND tAt K(AIONITORINGIREMOVAU O DOG KENNEL G DAIRY. <br /> DOUS WASTE GENERATOR ❑ CHICrtEN RANCH ❑ PKG TREATMENT PLANT <br /> TIE PSRNrTTEP AWLTIY ❑ MOTELIHOTEL ❑ PUMPER TRUCKrYARDICNEM TOIt.LT5 <br /> 7A OMODY PBIR IND - tl POOEJSPA P LAND USE APPOCATION SITES <br /> ME AL WASTE FA ILRY _ ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1 Ust up to n addresses In the space above. Select the typos) of files from the list above by chackin <br /> Me approi irlate box(es). At(cast one file type MUST be solacted. Fax to (2091464-0138 or mail to the <br /> r address ir dicated above. <br /> EHD will rotity the appGoant 1f any En files exist. An appointment for review wilt be confirmed <br /> approxim Lely five businoss days but no later than ten•(10) days after receipt of application. The files <br /> will be hefor a maximum of five business days for review. Appointments shuutd be sr;hedulad <br /> according y. <br /> A file that s,actively btinp worked on by EHO stair may not be tmmedlatcly available for review. A n <br /> applicatlo may be submitted when the file is available. <br /> A Any file n t returned Ih the time condition as releasad will be reorganized by EHD staff at the expon <br /> of the app (cant. Future file reviews by the same applicant may require a $59.00 deposit prior to rcvle <br /> 5 'TENTAT appointment dates must be confirmed with EHD staff. <br /> 6� Applicatio s received after 5:00 pm will be processed the next business day. <br /> l <br /> ON IRNIED APPOINTMENT PATE, TIME <br /> TE OONFIRMEO PHONE FAX INITIALS ��g <br /> n ED YES NO R<"EW DATE _ 4T r <br /> _ <br />