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ARRUCANT <br />a, <br />SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />304 EAST WEBER AVENUE, THIRD FLOOR [VUU <br />STOCKTON CA 95202 <br />(209) 488.9420 <br />PUBLIC RECORDS RELEASE APPLICATION. <br />TENTATIVE' APPOINTMENT DAT <br />(Plums I" <br />I—I CHECK aCX TO EXPEDITE Hi <br />SIGNATURE OF APPLICANT <br />FACSnAL@ �)r%(i y J Y <br />_ TIME <br />FOPnIia�4en siia+lilF4rD <br />IN 3 OUSINF.39 DAYS ,�®\7 <br />DATE 2� <br />ENVIRONMENTAL HEALTH DIVISION FILES M6U LL <br />UNDERGROUND TANK IU31) CLEANUP SITE (LOFT Q HOUSING A&ATEMENT \)Z SOLID WASTE FACILITY <br />OTHEFt CLEANUP SITE INON-LOP) C FOOD FACILITY NNEL`❑ 601-]1) WASTE VEHICLE <br />�9 UAZAFW0OUNOTANK SNSRA1)ftlNClREMOVAL) `4 CHICKEN RANCH T3 PKG TRIATMENT PLANT FEB 1 1 2800 <br />�n El bAWY <br />HAZARD OUSwA9T£65N6RATOR G PUWER TRUCIWARDitH9M TOILETS <br />C TIERED 501)FiTED FACIIYrY O PCOUS}IOTEL <br />G! TATTCalaODY PPlFOING C POOUSPA ❑ LAND USE pPPLFCATIOti SITES <br />M MCOICAL WASTE FACMTY '6r PUBUC WATER ",sr" ❑ OTHER (PLEA=- SPECIFY AU (YM <br />1. List up to ten addresser in the space above. Salvo/ the lype(a) of Fifes from the list above by oheaking <br />the appropriate box(es). At least one file type MUST be selected. Fax to 12091 40+0138 or m28 to the <br />matrass indi, d abava <br />2_ EHD wlit notify the applicant If any EHD files exist. An appointment for review will be Confirmed <br />approximatery five business days but no later than ten (10) days after r"elpt of application. The flies <br />will be held for a maximum at ms business Gaya for review. Appointments should be srfiedeled <br />accordingly. <br />3. A Me 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 file Is avauable. <br />4. Any file not raturn-W in th@ slime eaniaaon as rvleasad will be rebrganlred by EHD staff at the expanse <br />of tha appltcanL Future flis r*visws by tha same appiloant may rMAUire a $%8.00 deposit prior to review. <br />3. '"TENTATIVE appol ntmont dates must be oorrttnned with EHD staff, <br />6. AppHeations receded after 3:00 pm will be praaessod the nest business day. <br />CONFIRMED APPOINTMENT DATE <br />DATE CONFRMED <br />PHONE <br />WdBZ:je 07102 60 "Ta_d 9256 £86 60E : 'O <br />TIME <br />FAX INITIALS <br />TGTPL P.a <br />39L ❑9L "S ZOO : WodI l <br />