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04—i E-2001 TO 19259403632 P-01 <br /> kcewvto j, -h�' Lm <br /> (7b)AQUIN COUNTYP HEALTH <br /> I N-L LUV NllMiikli <br /> SAN usue H <br /> ENVIRONMENTAL HEALTH DIV1S10N <br /> uw F-AsT wkeat Avr=NuF-,THIRD FLOOR <br /> APR 1 7- 2001 STOCKTON CA 06202� <br /> TFt <br /> pps A <br /> L IC RECORDS RELEASE PPLICATION <br /> APPLiGANI <br /> ADOFtFss Gp in. Lq qpvqfTw.9 ,wt vp. s:rr. z(9.5* <br /> 963; Z <br /> 4f jV E* n�E, <br /> TENTATIVE*APMNtMENT DAME ;i� <br /> (PIMO give 7 to 10 business days fivm data of applIcal.11C <br /> CHIECK BOX TOEXPEO[TiE REMEST F.-REQUEST PA0043SED 3 BUI <br /> SIGNATURE OF APPLICANT DATEit jIM _ <br /> F"ADDREW THIS SIDE E8D STAFF USE ONLY <br /> PROOMM ELEMENTS$9A1;OR <br /> qLjr,o vr L d <br /> Zo aAe 49- F. Y .2 <br /> A 75�' Q <br /> CAJ� I <br /> 0- 4.4(1:r h 1/6- ; L.00 t 15'?-. <br /> 6 ro C k CFV It T -,6 1!93,-z 4;14 <br /> I 9.�oj. <br /> 91V Ld C Aeer-d AV �;-r 6a T .6-TZ <br /> z <br /> '!�M 4JIVEd 5 TV- C K <br /> ENVIRONMENTAL HEALTH I)TVISION �,ILES <br /> VU <br /> NVERG ROUN D TANK NST)GL�M UP WTZ(LOP) 0 HOUSING ABATEWNt i 41,13OLK)WA3TE FACILMY <br /> TkER CLEANUP SITE(NON4.0P) 0 F0013 FACILRY SOL16 wAsre vsac;LE <br /> %40ERGROUN D TANk(mowrorgmumovAw m DOG KENNEL CWRY <br /> PKG TREATMENT PLANT <br /> M CI*CKF.N RAMCM <br /> 0 MOTELAWTEL C3 PUMPER TALICV4YAFdMGHEm ToLETS <br /> VT=�A=ED FACILITY <br /> VA C^L OOMOOY PEIRCiNG 0 POOLISPA 0 LAND USE APPUCATION affEa <br /> carr OTHER(PLUAMSPEC"ASOV0 <br /> DiWASTE FAciLrry 0 PIUALICWATERSYSTEM E3 <br /> 1. List up to ten addra4sas In the space above. Select the type(a)of files from the list above by checking <br /> the appropriate box(e3). At least one file type MUST be Eax-taI909)454-0138 or mail t2 the <br /> 2. EHO will notify tho applicant if any END riles exist An appulntrT enl for review Will b&eanflrMad <br /> 2PPrGXIn%3t*1y five business days but no later than ten(10) dayi aftar receipt of application. The files <br /> will he hold for a maximum of thre busfnes4 days for rlevlow. ,4ppointments should be scheduled <br /> *CC4rdfnq1y. <br /> 3. A file that is actively being worked on by EHD staff may not be linmadlately available for ravloW. A naw <br /> aPPlicatlan may be submitted when the fat Is available. <br /> 4. Any file not retumed in the same condition as released will be reorganized by EHO staff at the qxpen" <br /> of the applicant. Future file reviews by the same applicaiit may rewire a$87-00 dopa*lt prior to raAaw. <br /> S. "TENTATIVE appointment dates must be conflmmd with I�Ijo stiff. <br /> S. Applications recstvid after 3:0-0 pm will he processed theinext b'Uslnezz day. <br /> CONFIRMED APPOINTMENT DATE <br /> DATE CONFIRMED <br /> PHONE FAX IWIALS <br />