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SAN- ', OADUIN.COUNTYPUELIC HEALTH " ;�:RVIGES <br /> ENVIRONMENTAL HEALTH ,Dnn4,A <br /> 3074 EAST WEBER AVENUE,THIRD FLOOR � <br /> -STOCKTON CA 95202° �' <br /> J U L 1 . !.,'is 1 (2-09) 468-3420 / <br /> PUBLIC RECORDS RELEASE XPPLICATION <br /> APPI.CANT_ 1�1 SAS._ BUSiNESSIAGENCY I W 11fr l <br /> 4 ADDRESS 23 AWd, <br /> t <br /> PHONE _ <br /> TENTATIVE'A?Pa1NTI4fEi+1 r DATE -nmE <br /> (Pleamm give 7 io 10 business days from data ofapPllcattcn submittal) <br /> CHECK BOX TO EXPEDITE REQUEST-$7 (IFE TPROCF-334IN11 SUSINFS3 PAYS <br /> SIGNATURE OF APPLICANT L—L _-- —_ IIAT <br /> FILEADDI�S5 !� <br /> AvLn <br /> • i <br /> VLo X53. � <br /> FI f <br /> �So.2�Y <br /> ' 35.:2~7 w . <br /> v 3.s fig' 44 <br /> q _ <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> { <br /> UNDERGROUND TANNIC(UST)CLEANUP SITE I>_OP) M HOUSING ABATE LENT SIS 0 SCUD WASTE FACILITY <br /> . OT14r-l2 C'r-A4tlP 51TE(KflN.LOP) 0 FOOD FACILITY I� ❑ SOLID WASTE VEHICLE <br /> UNDERGROUNO TANK(MQNIT'ORINGtR5MOVAL) Cl DOG KENNEL. 0 DAIRY <br /> HAZARDOUS WA57E GF-N=RATOR a CHICKE=N RANCH 'I� El PKG TREATMENT PLANT � <br /> 0 TIERED PERMITTED FACILITY 0 N1QTEL H0TEl- CI PUrdPER TRUCK[YARDICHEM TOILEM <br /> 0 TATTOMODY PEIRCING 11 PDOL.ISPA ;I� 0 LAND USE APPI.IGATION sf7 s <br /> ❑ ME=d; WASTE FACILlYY 0 PUBLIC WATER SYSTOW n OTHER(PLEASE.SPECIFY ABOVE) <br /> I List up to ten addresses in the space above. Select the typ(s) offilesfrom the list above by checking 4 <br /> th6 appropriate bo?ges). At least one 11110 type MUST be selected.!F to f709)464-0138 or mail to the <br /> re s jgd1catgo igb2ye <br /> 2. rzt-ID will notify the applicant if any EHB files exist. An appolntmo`nt for review will be confirmed <br /> approximately tivo business days but no later than ten (10),;days after receipt of application. The fifes <br /> will be held for a maximum of five business days for review- App'crinttnlents should be scheduled <br /> accordingly. i <br /> 3. A file that is actively being worked on by ZHD staff may not be fmmedlately available for review. Anew <br /> application may be submitted when the file is available. f i <br /> A. Any file not retut'tted in the sable condition as released will, reorganiied by EHD staff at the expense <br /> of thehapplicant. s=uture-file reviews by the same applicant may require a$78.00 deposit prior to review. <br /> S. 'TENTATIVE appointment dates must be confirmed with EN11 staff. ' <br /> 6. Applications received after 3:00 pM will be processed the next business day_ <br /> CONFIRMED APPOINTMENT DATE TIME <br /> ft <br /> DATE CONFIRMEDPHONE FAX INITIALS <br /> i <br /> REVIEWED y5s �... NO REVIEW DATE � <br /> k Bi 00 14 4110500 <br /> 7i <br /> it <br />