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PHONE H7. : 209 369 4228 _ Feb. 09-2000 09:03AM P2 <br /> SAN _jAOUIN COUNTYPUBLIC HEALTH SERVICES orocn uou <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST W Foca AVENUE,THIRD FLOOR <br /> STOCKTON CA DS202 <br /> (X9)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> - AP?ULAI(t� <br /> PHONE }' — Z2 FA"M1 Lx <br /> - <br /> TENTATIY[`APPaNTMENTDATE <br /> 011n p1w 7"W", <br /> 4usin� �y�yyy F. of a Tty� - <br /> PPlicaeae auLmJwll O <br /> CHECK 80X 70 EXPeDIT!REQUEST-4ra,00 PROCESSED IN 3 6U:WESS DAYS O <br /> SIGNATURE OF APPLICANT _ ( <br /> DATE <br /> V <br /> FILE AODRe3S ( t� <br /> { <br /> ice <br /> � I <br /> EMVIROItdaENTAL HEALTH DIVISION FILES <br /> * NOERORODMO TANK[UST)CLZAWP 317x[(LOP[ 6 HOUSINOAUATEMtENT ❑ SOt.m TYASTE FAGUt7 L't <br /> OTHER CLEANUP W"(NON.&M a Poon FACILITY Cl Row%V"-TL VFNK:LE FEB 10 2000 <br /> "5f UNDMIGROUND TAMK[MONITQrtM!RE6tOVs1) a DOGKEHN" ❑ DAIRY <br /> IIJ.HAZAROOU3 YfA1rMU"EftAT0R Q CK"MN RANCH Q PKO TREATMENT F[.4NT <br /> C TiERI.7 PERMITTED FAGIL'Y ❑ MOTELlNOTEL 4 PUMPER TMEN PtANTNFAI TOILETS <br /> Q VLUIC.TATTOFOODY Pf:rACU Q POOtl3PA Q LANK)USE APPUCAT,ONS7MS <br /> Q NEDIOALy)ASYt:pAGILIJ'y a PUhUC WATER SYSTEM O OTHER(PLEAaE SPEC.FY AU0M <br /> '1 List up to ton addrett0s in the spa"above, Select the type(&)of flies from the nst above by chacking <br /> tete ttppropriata bo.Y(es). At least onv fns typo MUST be&e[eded. pOJEt4(2p8)464-0139 ormafl to the <br /> PS1SfL9P&rL+�ISAte�i IIg3Ys� <br /> 2. gND Witt notify the appttaarrt if anY EHD files exist. An appoiniment for revfaw will be confirmed <br /> approXlmatety five bU51n0SS days br,t no Tatar than ten(10)days after receipt of applimtion. The files <br /> will be hold for a maximum of five buslnoss days for favfew, Appointments Should be Scheduled <br /> accordingly_ <br /> 3. A rile that is actively being worked on by EH❑etaH may not be 4=ec5dtely aVellable for rainew. A new <br /> appticetion may be submitted when the flle Is available. <br /> 4. Any(He hot mturnrd in the Came condition"rele"ed will tae morgantxea b v at the expense <br /> Of the applicant. Future file reviews b _ icaht_ Y -liD start <br /> 5. 'TENTATIVE aPPOInt tont date&Mustybebe conflnnad wlith END staff.uire a 570.60 dcpo3it pri«to revFew- <br /> 6. ApplicaHoh9 racefved after 3_00 pm will be processed the neXt bUSinasa day- {k <br /> CONFIRMED APPOINTmen DATE TIME f <br /> DATE CDN!`IRMEG PHONE FAX INITIALS <br /> I i <br /> • REVs�� VFS NO PFVIEty DATE <br /> TOTRL P.O3 <br />