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t,.J L:h....n•L.� <br /> N J( aUIN COUNTYPUBLIC HEALTH S VICES <br /> 'ENVIRONMENTAL ENVIRONMENTAL HEALTH DIVISIOry �u�S <br /> 30a EAST WEBER OCC-AVENUE,THIRD FLOOR <br /> STOCK-TON CA 95202 <br /> (209)4683420 <br /> PUBLIC RECORDS <br /> RECORDS RELEAnS{E APfPLICA�JT/JII?Np � <br /> APPLICANTo do �min_e. 1 G �/11 B�U./3-Iy�NESSIAOIENNCY L((/Q� Ny/1Py__C��_`u� "L �U i{/�F � •�yC <br /> ADDRESS <br /> .123 ! J///L7aw qko � -tock.o& 1, ' <br /> PHONE i,W? FACSIMILE d409- <br /> TENTATIVE'APPOINTMENTDATE , a/ TIME <br /> (Plaase give 7 to 10 busln s days from date of application submittij CJ I <br /> �,f/' <br /> CHECK BOX TO EXPEDITE REQUES 78.00 FEE-REQUEST ROC SSED IN 3 BUSINESS DAYS �-- <br /> SIGNATURE OF APPLICANT DATE ✓ ��/ <br /> FILE ADDRESS O <br /> n <br /> Xo 8/ / <br /> O r► r . .• + -2 9f 20 <br /> rr p r � N <br /> it14 <br /> r r e. rr io/b a3 r•�a� �3 <br /> mer' rr <br /> i e asQr r zo cl, a o 0_ boa cz z azo f <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSING ADATEMENT ❑ SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) 'Cl. DOO KENNEL ❑ DAIRY J <br /> HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERM17` FE)FACILTTY Cl MOTEVHOTEL ❑ PUMPER TRUCK(YARDICHEM TOILETS <br /> ❑ TATTOOBODY PEIRCING ❑ POOUSPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILTIY ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <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 appropriate box(es). At least one file type MUST be selected_ Fax to 12(19)464-0138 or mall to the <br /> address indicated above. <br /> 2. EHD will notify the applicant if any EHD files 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 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 new <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 Future file reviews by the same applicant may require a $78.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with END staff, <br /> 6. Applications received after 3:00 pre will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EN 04 U D4 MY <br />