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1-3�-19ti Ls1:- +ari i-MOIL iii i _;t�_w:'�'i7 F'.u_ <br /> ew re wearvLo A <br /> GSAOAQUIN COUNTYPUBLIC HEALSE <br /> \ F_NO L[x's I1l1MBF4 <br /> ENVIRONMENTAL HEALTH DIVISIONp/ p�5 <br /> 304 EAST WEBER AVENUE,THIRD FLOOR 4 ." '� l g Df <br /> STOCKTON CA OS202 <br /> (209)463-3420 DEC 2 3 1999 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> aPPLICaNT HH'.CK S„�Jy,4 �vit \; r•I ALTH <br /> .. BUSINESSIAGENCY dY/ J <br /> ADORE3s2345 i'filEvlty✓ T.3'il�r`f�rhxl CIO oz <br /> PNoNE £' iLill?-`I5il FACSIMILEg311Z{79-417 7 .__. <br /> TINTATIVE"APPON—„ AERTDATF—A_ � Z./y�ry "WtE o --- <br /> (Please g)�z 7 To 10 bUsiltess days from dale of applicau.submrtreq <br /> CHECK BOX TO DCPEWE REQUEST <br /> --4-78-0 E-REQUEST PROCESSED IN 3 SWINE5S DAYS <br /> SIGNATURE OF APPLICANT DATE /� 2 <br /> FILE ADDRESS <br /> 340 AW ye' 1 <br /> O <br /> A40,1761 S , c (1G <br /> S- o 51. r t < <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> ® UNDERGROUND TANK(UST)CLEANUP Sffr(LOP) ❑ HOUSING ABATEMENT Cl SOLID WASTE FACILITY <br /> H OTHER CLEANUP SITE(HON-LOP) O FOOD FACILITY O SOLID WASTE VEHLCLE <br /> In UNDERGROIINO TANK(MONfromwl Rr=mavAL) Q DOG KFHNEL ❑ DAIRY <br /> ® HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY Q MOTELIHOTEL ❑ PUMPER TRUCKIYARDICHEM TOILETS <br /> o TATTOOIDOOY PEIRCWG ❑ POOLSPA ❑ LAND USE APPLICATION SrrES <br /> ❑ MEDICAL WASTE FACILITY CI PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE_) <br /> 1. List up to ten addresses in the space above. Select the types)of files from the list above by checking <br /> the appropriate box(es). At least one rile type MUST be selected. E; cZto_ (20946” 38 or In to the <br /> addTees indid,�gd above. <br /> 2. EHD will notify the applicant if any EHD files exist An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10) days aftei'recelpt of application. The files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively being Worked on by EHD staff may not be immediately avallable for review. A new <br /> application may be submitted when tht file is available. <br /> 4- Any file not returned in the same cohdition 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 SMOD deposit prior to review_ <br /> 5. 'TLNTATIVE appointment dates must lac r-anfirrned with EHD staff. <br /> S. AFPIICations received after 3.00 pm will be pfoceSsed the next business day. <br /> •r° > � � � I-ix"C''^''i+ k,��l'�h"F' g7,'C�rl:y,�'"�y ItY'1T°ri dF.i',.:°� ?`��'o�m �,��'�'1�'i"�ro�)Ff �;f� e� <br /> R'oUIEV1IED..L._d rls r`.�ESx r w r �.:s _NO �f& �t7 rs�'✓7 'J Y r ': � w it - <br /> wess <br /> TTITAL 12.1132 <br />