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I `lkve� I I e1�u Lv�.nunuf ek <br /> Y SANUlN GOUNi"YPUBLICHEALi'H S ICE1; ,\ <br /> I1v ENVIRONMENTAL HEALTH DIVISIO <br /> �� 304 EAST WrJ5FR AVENUE, THIRD FLOOR <br /> CCC STOCKTON CA 95202 <br /> (209)46a-8420 I <br /> PUBLIC.RECORDS RELEASE APPLICATION <br /> APPLICANT �Okj HtiS1NS5�1A�GEliCY <, 02000 <br /> ___,, .... . <br /> ADURESS I�� �� �r. 3le 9J 0O. -!VV!HJNPv1E. ijiAi_ I-'EALTH <br /> -�4� <br /> (q n�1I ; IA /. LF;Vic LS <br /> FACSIMILE r�� ��� - ��s <br /> TENTATIVE"APPOINTMENT DATE 1 Y��J ob TIMF It CDC) pm race-0y+� <br /> (P) eso give T to 10 business days from date afapplloatlon su4mtttal] <br /> CHUCK Box To aXPEDLTE REQUOT-$MOO FEE-RGQ ` P 6Sefi0 N]91.11tIN ESS DAYS <br /> SIGNATURE OF APPLICANT G= DATE f <br /> FILE DRESS THIS SIDE EMD STAFF UAE ONLY <br /> I PROgRAs4 pLFA�NT$SEARCH <br /> 1 UI. 3 "0 - <br /> _ <br /> of P� c o <br /> 1 S 4- <br /> -- O <br /> ENVIRONMENTAL HEALTH DIVISION FILES (� <br /> UNDERGROUND TANK(UST)CLEANUP SITE ILAP) ❑ HOUSING ABATEMENT O SOLID WASTE FACILITY t�J <br /> OTHER CLZANUP SITE tNON{.OFI A FOOD DOC ACLl 10 SOLID WASTE VEHICLE <br /> 0 <br /> UN4RUROUNO TANK(MONITORINUI WAGIVAL], <br /> HAZARDOUS wAATE GENERATCH ❑ GNiCKER RANCH 0 PKQ TREATMENT PLANT <br /> P TIKRGD PGRMri Mn fACUATY , 0 MOT111"OTAL M PUMMA TSUCWYAROICr¢N TORCTIi <br /> O TATTOOMODY FORCING 0 P00U3PA O LAND USE APPUCATION SITES <br /> ❑ MIDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM 0 OTHER(PLEASE 5FECiFY ADOVEI <br /> 1. List up to tan addresses in the space above. Select the type(s)of tiles from the list above by checking <br /> the Appropriate box(es)- AS least ono We type MUST ba selected. Fox to IZ091464-018 or ai to the <br /> addtess Indicated above. <br /> z. EHD will notify the applicant If any EHo rues exist, An appointment tot review will be confirmed <br /> approximately Ova business days but no tater than ton (10)days after reUvIpt of application. The files <br /> will b3 hold for a maximum of five business days for review. Appointment$ should be scheduled <br /> aaordingly. <br /> 3. A file that to actively being worked on by EHU staff rosy not be immediately avallabla for review. A now <br /> application may be submitted when tha file Is available. <br /> A, Any Elle riot returned In the same condition as relaased will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicalri may require a S78.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be Confirmed with Ef-W haft. <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 INITIAL,$ <br /> REVIEWED YES NO REVIEW DATE <br /> T <br /> Iulu� N.we <br />