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12--H2•-x,999 dd-21PM FRfaM TO 1415F3�343300 P. <br />W7p iiEGENFA <br />�I <br />SAN JOAQUIN CQUN`3'Y'PUBLtC HEALTH SIDES <br />ENVIRONMENTAL HEALTH DIVISION <br />304 EAST WEBER AVENUE, THIRD FLOOR <br />STOCKTON CA 95202 <br />(209)468-3420 <br />PUBLIC RECORDS RELEASE APPLICATION <br />EHO `OG hMSER <br />APPUCANT N i i (� Lr4�ra 6Usuaesa1A0CNCY 9M'[>'w( �'U&dej <br />qo 'Dt6rnttr`:� (ve Novaty CA- ttfRg-, <br />,,.DRE,,,.� <br />rrlorlti -'t �� 3� o f FACSIMILE Aif 5 2- 3 3r D <br />�Ataas wir-0� <br />TENTATIVE* APPOINTMENT OATS <br />(1*16-mm Alva r to i ® bVAll s Mays voen este of appsc"an suer, wal) <br />-)kl AWWOP A i r rzNfirtt v A ,5 — <br />In CLICK SOXTO EXPFOIrE R,EQU - PEE - REQUEST PROCESoh IN 3 SL131WE3$ DAYS r - <br />SIGNATURE OF APPLICANT / — I L— - —BATE •� /9 <br />` / <br />ENVIRONMENTAL HEALTH DIV! 10" FILES <br />r NDERGROUND TAW (UST) CLEANUP SITE (L. PD ❑ fiOUSING ABATEMENT a SOLID WAVE. FACMIiY <br />tJ qY} �xCLEANUP $rT6 (NON -LOP) CJ FOOD FACILITY U SOLID WATER L' 111CLA <br />UNDiwROROUNb TANK pw0WORINGIREMOVAL) ® 000 KENNEL C3 OAiR't <br />0 HAZARDOUS WAGn QMRATOR ® C14ICKFN RANCH d PKG TREATMENT PLANT <br />O nimso Prmma £o FACILr Y ❑ NKftIJH0TEL lJ PUMPER TF UCKIYARDNGMEM TOLETS <br />0 TATTOMODY PURGING O PO LJSPA Q LAND USE APPLICATIO14 SITES <br />0 14 WXCAL WASTE FACILITY 0 PUSUC WATER 3YSTt M E3 OTNER (Pi L4U SFLCIFY ABOVE? <br />1. Liam up to ten addresaea In the xpaca alagva., $efeCt the tYpe(s) of flies from tnO list Obove by chocking <br />U* appropriate box(es). At least 066 file We MUST be selected. Fax to 4209 404-Qj38 or matl to the <br />addL4M Indl&rated aba= <br />2. EHD will notify the applicant It any Eli® files exist An appointment for review will be confirmed <br />approximately five buainwm days but no later than ten (10) days attar recalpt of application. The files <br />will be held for a maximum of filve business days for reYiew. Appointments should be scheduled <br />accordingly. <br />3. A file that is activaly being worked on by EHD staff may not be immediately available for review, A now <br />application may be submitted when the filo is available. <br />4. Any 1118 not returnwJ in the same Condition a3 released will be reorganized by END ataft at the Renee <br />of the applicant. t vtvro file reviews by the same applicant may require a $78.00 deposit prior to review. <br />'TENTATIVE appointment date& must be confirmed with EHD staff. <br />6. Applications raaeived after 3_40 pm will be processed the next business day. <br />m <br />�i4wt�ne.BL 4,0 2/1 / )--�lO l(:5`� <br />TOTAL P.02 <br />FILL: ADDREW <br />if WE 57 <br />p iUrJ �- l . LCS i" C �'_t�c5>✓ r_c 5i_5 <br />-- l V div <br />SGkT�N - I�WSi <br />�0 G 6Cc N { tS RASE~ !"IS <br />j t I-1 c <br />s -rot -ro" -- I," sr` z;� <br />ENVIRONMENTAL HEALTH DIV! 10" FILES <br />r NDERGROUND TAW (UST) CLEANUP SITE (L. PD ❑ fiOUSING ABATEMENT a SOLID WAVE. FACMIiY <br />tJ qY} �xCLEANUP $rT6 (NON -LOP) CJ FOOD FACILITY U SOLID WATER L' 111CLA <br />UNDiwROROUNb TANK pw0WORINGIREMOVAL) ® 000 KENNEL C3 OAiR't <br />0 HAZARDOUS WAGn QMRATOR ® C14ICKFN RANCH d PKG TREATMENT PLANT <br />O nimso Prmma £o FACILr Y ❑ NKftIJH0TEL lJ PUMPER TF UCKIYARDNGMEM TOLETS <br />0 TATTOMODY PURGING O PO LJSPA Q LAND USE APPLICATIO14 SITES <br />0 14 WXCAL WASTE FACILITY 0 PUSUC WATER 3YSTt M E3 OTNER (Pi L4U SFLCIFY ABOVE? <br />1. Liam up to ten addresaea In the xpaca alagva., $efeCt the tYpe(s) of flies from tnO list Obove by chocking <br />U* appropriate box(es). At least 066 file We MUST be selected. Fax to 4209 404-Qj38 or matl to the <br />addL4M Indl&rated aba= <br />2. EHD will notify the applicant It any Eli® files exist An appointment for review will be confirmed <br />approximately five buainwm days but no later than ten (10) days attar recalpt of application. The files <br />will be held for a maximum of filve business days for reYiew. Appointments should be scheduled <br />accordingly. <br />3. A file that is activaly being worked on by EHD staff may not be immediately available for review, A now <br />application may be submitted when the filo is available. <br />4. Any 1118 not returnwJ in the same Condition a3 released will be reorganized by END ataft at the Renee <br />of the applicant. t vtvro file reviews by the same applicant may require a $78.00 deposit prior to review. <br />'TENTATIVE appointment date& must be confirmed with EHD staff. <br />6. Applications raaeived after 3_40 pm will be processed the next business day. <br />m <br />�i4wt�ne.BL 4,0 2/1 / )--�lO l(:5`� <br />TOTAL P.02 <br />