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PI0..4; P.' <br /> IDI. 13,2OC1030 4=44PHm TREH-VELi ^>. P�-'LU�� To 14159$59041 P.01 <br /> VA, wd�vl.t,•_•.• sliu�w Nuruw <br /> j �r DsaN JOAQUIN COUNTYPUBLIC H4N SERVIGFtSro , �r a <br /> E,NVIRONMBNTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUg,THIRD FLOOR <br /> ST � m <br /> OCKTON CA 99202 <br /> (�i J/ S <br /> oq-) yL,.t.}.0j V (209)468-3420 '�x'✓1 20 <br /> PUBLIC RECORDS RELEASE APPLIC0 ;1;, QO <br /> ,0 <br /> i A.PPUCANT 1 I} t pp aUSINESSIAGENCY <br /> ' AnORESS <br /> i#C <br /> PHONE FACSIMILE <br /> TENTATIVE'APPOm TMP_t-1T DATE too TIME! <br /> (Pleur afvi 7 tot h4Gi s days feaAlrlala of appiia Uo Sutlrtllual)r <br /> CHECK SOX TO E-RE: E5T PRCC=Ep IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT . DATE G <br /> 1 <br /> ' IF1LG ADD4E6S TNI$WPE EIS STAPF USE ONLY <br /> ' PROGRAM PLEnNTS SEARCH <br /> T S <br /> i <br /> ENVIRONMENTAL HEALTH DIVISION FILES SUN B <br /> tC <br /> St(DE.RGROt1NDT4NK((f5-n CLEANUP SITE{LOP} IDNOUSlNGAELA'TEMEflT b SOLID Y[gSrE FA6C_1TY <br /> Tl-IE9 CL ANUF 51T'a(KOK-LOP) FOOD FACILrrr IT SOLID WASTE VEHICLE <br /> (i-iNDF1ZGR0,VND TANKOXI-40MN" OVAQ O ODG KEI4.N:L. 0 DAIRY <br /> W-AC1RDOU5 WASTE G@NEPATOR 6 CN4KEN RANCH ❑ PKO-TREATMENT PLANT <br /> :C TIER"PM- MITTED PACILYIY , to J40 ELMOTEL ❑ PUMPCR TRUCWYARLP4—wt ESE YOa.ETB <br /> ❑ TATTOOIRODY P3RONG ❑ PDOIJSPA ❑ U.NO UtE aPKIC-9T10P:>3aEr, <br /> 0 MEDICAL WA57E FAC)Lrry O PUBLIC WATER MTEM ❑ OTHER(VI—FAIR SPECIFY ABOVE) <br /> ,•T. List up to tan addroSsn_s'in t-4e spares abavo. Salaet the type(5)of MP5 from tic ilei abova try cliocking <br /> { <br /> th- approprlate box(as). At least one file type MUST be"loot Fax tU (rGSt c ca G1�$ �r fnai!tea Lh <br /> �rldrsya Indd°:�tsG abava. <br /> I2. !J 1D will notify the applicant if any EHD'fiies »xist. An uppointmont for t--v.',-:rr.'ld ba wnfinnad <br /> appro>urn2tsly fik . buslress days but res Ixtar t'i.an ten (10) 4+ay&after rcr-emt of appltcatfon. Thu fits& <br /> will bo nadd for a maximun olfiva bu:ineSZ days for raV,7w. Appointrnents should b9 SchLd'uwd <br /> A fll tha; is z;et1v4jy boino worked on by EHD Staff may not bra Immediately avaAabie for roview. A n--.v <br /> apOGcntion may be subrn: trw wismi t2he filo is avaitabio- <br /> 4. Any file not mturrwd in Ehe sena =nd@tion as r;AQaase-- W-al b= morgania<^d by EHD ctaff at the trRPsnsz <br /> Of the applicant_ Future fila reviews by the zamn applicant may raqu!re a$T8.Q0 depOsft criOr Ea review. <br /> 'TE41TATivL appointment dates must ha confirrmd witti EHD ataft' <br /> Applications re oivod after 3:00 pm wE.) ba processed th= next busine" day. <br /> ( ONc IRN"iED APPOiN-rMENT DATE TWE <br /> l ATE CONFiRI.ED PHONE 1=A;: INITIALS <br /> VIs' NO - REVIEW D TE <br /> �' : .` TOTAL P.01 <br />