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-- . .un „�.. <br /> 01.2d.OU ri<i 1u:au PAS buzrur TO <br /> r <br /> -- c�a tx+wecc L <br /> 10:16Ail FROM _ <br /> - - SAW IOAQL'!N r_-OL'NTYDIIRI IP I-IFAI TW RER rFS C ,� <br /> F AR(TNMFNiTA I H <br /> IVIHEALTH WVISION <br /> 304 FAST WF_EIER AVENUE.THIRD FLOOR _ <br /> STOCKTON CA 95202 <br /> (209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> I <br /> gppUCANT BU51NESSIAGENCY <br /> JC�Q✓1 CDDK <br /> nnnpc5s 7731) �cr1 w/nGnl✓le <f Tlio(of,o. /I/Penn 9?rJ�� <br /> PHONE FACSIMILE D <br /> 5 {P TIME <br /> TENTATIVE-APPOINTMENT DATE <br /> (Pfp ,glvo 7 to 10 busioa5s days trom date of appOratlOn sabmihal) FEB 3 2000 <br /> CHECK BOX TO EXPEDITE REQUEST-578. FEE-REST PRDATE OCFSSED IN 3 BUSINESS PAYS �^ OD <br /> 7 <br /> SIGNATURE OF APPLICANT <br /> FILE ADDRESS <br /> 5 ANO P CP 66 S q,r o4w folth� LYS* <br /> p—� <br /> FJj- I T}Pr0 �'� rrSi'!)PS yYD 7 S Air J.elf Wry <br /> 1 v {nln LL <br /> bfi "r_ /fTOnURivC /r OS1 seorly R00 Fr /PS <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> ❑ SOUP WASTE FACILITY <br /> rl UNDERGROUND TANK(U57)CLEANUP SITE(LOP) El HOUSING ABATEMENT 173SOLID WASTE VEHICLE <br /> O OTHER CLEANUP SITE(NON-LDP) O FOOD FACILITY E3 DAIRY <br /> C3 UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ 13 KENNEL ❑ PKG TREATMENT PLANT <br /> G HAZARDOUS WASTE GLNERATOR O CHICKEN RANCH ❑ rUr4pER TRUCKITARD)CHEMTOILETS <br /> n TIERED PERMITTED FACILITY ❑ MOTEUHOTEL p LAND USE APPLICATION SITES <br /> ❑ TATTOOIBODY PEIRCING ❑ POOUSPA ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM <br /> 1. List up to ten addresses in the space above. Select the types)of tiles from the list above by checking <br /> the appropriate box(es). At least one Tile type MUST be selected. <br /> c r2091 ara_ptz8 or mail to the <br /> address indicated above <br /> Z. EHD will notify the applicant if any EHD Tiles exist. to appointment for review will be confirmed <br /> approximately five business days but no later than ten(T O) 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 /> ? A file that is actIvcl)r being worked on by EHD staff may not be immediately available for review. Anew <br /> application may be submitted whet•,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, <br /> 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRf:ED <br /> PHONE FAX INITIALS <br /> ` REVIEWED YES NO REVIEW DATE <br /> EM o0 14 mLoa TOTAL P.02 <br />