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04-!IG-2001 013:5:::':-- TO 19259409632 P.01 <br /> RikVal{KkCC1YeD � Elie llJ4 NuailWl <br /> �(_,i� ' SAN OAQUIN COUNTYPUBLIC HEALTH aMRV10ES 1 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> p,P( 1 7 Z0304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 86202 <br /> N`JI ',ti:vtl�i4iHtP,LiH (209)460-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT Yh L22CkTi l4 CV/YS TSI-�Sr aUSINES31AGENCY 6 el6 r F/V r.o1C/s <br /> ADDRESS -6��yy1 ! W- L.CJS �Pa9lS j?G Vl�. Sp. <br /> i <br /> PHONE � 5 PACSIMILE / 2-S Q� 963 Z . <br /> TENTATIVE"APFOINTMENT DATE W Z N 1, TIME <br /> (Plaaae give 7 to 10 busine days from dats of appllcation submittal) <br /> ® CHECK BOX TO EXPEDITE REQUEST Z.00 FEE-REQUESTES <br /> ESPROCSED 3 BU ESS DAYS <br /> SIGNATURE OF APPLICANT y 2 T%° "� yh r- DATE Z?- �7�/ 17 <br /> FILEADDRESS 'S <br /> SIDE END STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> Rlrc; r L6 2 <br /> 2 D 35a. <br /> Z C,4 - iS c9 <br /> May <br /> O cos/ 2 35�Z��N <br /> c cr coir 9S <br /> ' d H CLOt,•Gh 9 A � i i <br /> K D r, f giro �9s� MZ <br /> - <br /> -ST-0 C tc ry N10 1:r'Z V <br /> �/ ENVIRONMENTAL HEALTH DIVISION FILESE <br /> L4 NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑ HOUSINO ABATLUENT yaI SOLID WASTE PACILITY <br /> HER CLEANUP SITE(NDN-LOP) 0 FOOD FACILITY IJSOLID WASTE VEWCLE <br /> YOERGROUND TANK(MONITOMNOiREMOVAL) P DDG KENNEL ❑ DAIRY <br /> U`./i;AZPRDOUs wA9TE rENERATOR rl clilm-N RANCH C] PKG TREATMENT PLANT <br /> T9 TIERED PERMITTED FACILITY ❑ MOTEUHOTEL C3 PUMPER TRUCKJYARDICHEM TOILETS <br /> ❑�ATTocMODY PEIRCWG O POOLISPA 13IAND USE APPLICATION SREB <br /> D'M1l''DICAL WASTE FACILITY 0 PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPCCWY ALCOVE) <br /> 1. List up to ten addresses In the space above. Select the type(s)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to (208)464-0138 or ingli toShe <br /> address Indicatyd above <br /> 2. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> epproxlmatelyfive business days but no later than ten(10) days after receipt of application. The flies <br /> will be held for a maximum of five business days for review. Appointment$should be scheduled <br /> accordingly. <br /> 3. A file 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 available. <br /> 4. Any file not retumed in the same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Future File reviews by the same sppilt.ant may require a$87.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> I <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> i <br />