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2600 W:MPM FRO u, <br /> ... �, FADLOONUMIIER i <br /> t " SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES } �j <br /> ENVIRONMENTAL HEALTH DIVISION T' ` <br /> 304 EAST WESER AVENUE,THIRD FLOOR { <br /> STOCKTON CA 95202 s <br /> tel' Qq� (209) 488.3420 <br /> ;; (¢ PUBLIC RECORDS RELEASE APPLICATION <br /> { L(GAN7_ YlA �aC l BUS(NESSfAGkNCY may --IBJ y9'l 10 <br /> �' . � t <br /> QRESS 2,, II _ <br /> �'I <br /> 1 ,`'• Jt7NE � Z' I FAG51WLB 5�0' `f oL• -I W j._ `-• <br /> J o�d!af'Qm <br /> Tad -�- <br /> m':; I� TENTATIVE"APPOINTMENT DATE q <br /> aria flue to 10 usmea4atc of apAliuu submUtap <br /> dddaftt"F EST-$87.00 FEE-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> 'GNATURGEOFAPPLICANT �� ej�. UATi o0 ; <br /> �. FILE ADDRESS THIS SIDE EHn STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> i r Rd. CA `i5240 � 2 CJZ7 <br /> •�). 41J 1 t � �l C l I <br /> g; •' OO Yr_ Vicfror• Rol > Ln T CSt KI( Zq <br /> �: iclnr R� Lord <br /> ` M= S(o L�c.kCforc-) Lo i I <br /> w IN _or k� � ) LOA; 7 Q <br /> at 00 Beet vrl a F1 a L-a�P+ a�/.t.t'17�S <br /> �+ <br /> El I <br /> oo �i c o�f' nt• LD <br /> (F + 2 3 ENVIRONMENTAL HEALTH DIVISION FILE$ <br /> I / <br /> SOUL)WASTE FACILITY <br /> UNDERGROUND TANK(UST)CLEANUP$ITE(LOP) ❑ HOUSING ABATEMENT CI SOLID WASTE VEHICLE <br /> DYHER CLEANUP SITE(NON-LOP) d FOOD FACILITY <br /> ...UNDERGROUND TANK(MON{TORING/REMOVAL) ❑ DOG KENNEL � ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH It PKO TREATMENT PLANT , <br /> JIPRLD PERMITTED FACILITY 0 MOTEL/HOURTRTEL PUMP UCKICASE APPLICATION N REB <br /> MTOILETS _ <br /> TATTO(YDODYPEIRCING ❑ P60LISPA <br /> M�OfGAL WASTE LAND U <br /> FACILITY <br /> PUBLIC WATER SYSTEM 0 OTHER(PLEASE SPEC{ ABOVE) <br /> jQ <br /> .�, 1 <br /> 1 List up to ten addresses in the space above. Select the type(s)of flies from the list above py checking <br /> the appropriate box(es). At least ono file type MUST be selected. Fax to(209) 464.01 or mall to the <br /> ' ( r_ �n�,ik,,sted above i <br /> �. FHD w01 notify the applicant If any EHD files exist. An appointment for review will be confirmed <br /> approximately flys business days but no later than ten(10)days after receipt of appilca6ofL The files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> acc Ordingly. <br /> Afiie that Is actively being worked on by EHO staff may not be immediately available for r4vlew. A new <br /> applle stion may be submitted when the file is available. j <br /> Any file not returned in the same condition ae released will be reorganized by EHD staff at the expense ' <br /> of the applicant. Future file reviews by the same applicant may require a $87.00 deposit p(ior to review. <br /> ••viii 'TENTA'i F_ appointment dates must be confirmed with EHD staff. <br /> Applleatic`,-Is received after 3:00 pm will be prococaetl the next business day. <br /> 1 <br /> CONFIRMED APPOINTMENT DATE � _•_ TIME <br /> DATE CONFIRMED PHONE FAX WtT(ALS _ <br /> nm uc��)r_n vra un IUL1nGW nA70 - j <br />