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84-16-2Fy21 6N s.�:'. - �1 TO 1925540% 2 P.01 <br /> p�°..rtntcelvta 1,11UWu Nur <br /> Zl ,i SAN JOAQUIN COUNTYPUBLIC HEALTH SERVIGfEs `1 <br /> ENVIRONMENTAL HEALTH DWISION <br /> APR 17 200 344 EAST WEBER AVENUE,THIRD FLOOR b <br /> STOCKTON CA 86202 <br /> (208)46e-3420 e <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT C y�-qqs lk..,,J i/1! CV/fi(97d9•N70U5INE931AGENCY C7 eta c e,A/ 0/C/ <br /> ADDRESS <br /> PHONE �'Zs " /�(I� ?� 3L FACSIMILEIfI 92.5 " d- .9632 <br /> i TENTATIVE"APPOa1TNENT DATE =IVTINE / <br /> (Plow give 7 l0 10 txmtneas days from date or applicaUan submittal) <br /> I CHECK BOX TO EXPEDITE REQUEST 7.00 FFE�E�-REQUE <br /> ST PROCESSED IN a DU NESS DAYS <br /> SIGNATURE OF APPLICANT I%''"v�`y+�— �i�+�^a�r'y`� DATE •0 <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> Lr d y JZ L 6 2 310 381 o z w qt a =jy <br /> o <br /> 2 zD 5 a z 8l o %4 20 2.2. <br /> Z L - 4X401, S d N G <br /> o O o�! 2 N <br /> c cr coir 9S N 4. <br /> dc( fy CCOLrGk D 1.0� i Ny. w <br /> D v 9e D T E c <br /> 03) ( 9 2 <br /> 62t/ 4,V C ;2!3 V 4-q55, o <br /> L r C 238/ <br /> 5TVCK s2 ® 0 2300 �3 <br /> 46- <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> N AN / n/1n rit,����D <br /> NOERGROUND TANK(UST)CLEANUP SITE(LOP) C1HOUSINO ADATEIIE ® <br /> NT SOL®WASTE "WTI? <br /> HER CLEANUP SITE(NDN4.OP) ❑ FOOD FACILITY ❑ SOLIDWASTE <br /> �NOERGROUND TANK(MOMTORIN0/REMDVAL) CI DOG KEIWEt ❑ DAIRY MAY - 1 2001 <br /> .I{AZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH 0 PKG TREATNENTPLANT <br /> I Ig'TIERED PERMITTED FACUX[Y ❑ MOTELIHOTEL ❑ PUMPER TRUCKNARD/CHEN TOiIETB <br /> ' ��ATC0p180DY PED2CWG ❑ POOLJSPA 13 LAND USC APPLICATION SITES <br /> Q�MFAICAL WASTE FACILITY 0 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 abave by checking <br /> the appropriate box6s). At least one file type MUST be selected. Fax to t2O91464-0133 or mail to the <br /> address in(�Ip 4a ad abovg, <br /> 2. EHD will notify the applicant If any£HD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10)days altar receipt of application. The files <br /> will be hold for a maximum of five bustnes4 days for review. Appointments should be scheduled <br /> accordfng)y. <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 ids Is avaitable. <br /> 4. Any -ta not retumed in tho same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Future file rovirns by the same applicant may require a$87.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must ba 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 CONFIRMED PHONE FAX INITIALS <br /> i <br />