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Z4-1fi-2001 08;51141 03M TL� 19259409632 P.01 <br /> :,.In iucvrrr0 tr ux:mx+4u, <br /> SARI JOAQUIN COUNTYPUSUC HEALTH SERVICES <br /> i ENVIRONMENTAL HEALTH DIVISION ` 5-,2- <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> I2oa)ass aa2o ° +Y 3 0 2001 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPIJCAN7 YftL�N{( GD,y STA,vTIy HUSINES&AQENCY `9F �CON CD�YSCIL t�/�.l✓T �r,l'Y CIh <br /> ADORE <br /> sS 56730 A/ Los 9os1TgS a�VDd 5i�2mS <br /> PHONE 92S 51 3 z �f{AGSfWL/C/ 9 2 s- 9�t O - 9+�3 2 <br /> TENTATIVE*APPOINiMPI'DATE " /7 O(/ TIME <br /> (PlsAta Alva 7 l0 10 bw dors hvm dale vl appllcoLOn AuGmIThN) <br /> L-1 CHRCK SOX TO EXPED"REQUEST-3a7.00 FFEpEE—REQUEST PR ED tN J BUSINESS DAYS <br /> SIGNATURE OF APPLICANT T2 V` ^ 'l1/�� DATE <br /> FU ADDRESS THIS SIDE EHO sTAFr USE ONLY <br /> PROGRAM ELEMENTS SZAR" <br /> 1404 OUT ST, S OCkro 3.5_- 4_c — <br /> - 6o SBvr S7 Tac.tTv <br /> '. c r� w Y s po c To .z -z 9 Coe) rvL,: <br /> /fie R Oc-TO 3s•a , <br /> A. <br /> - <br /> i <br /> / EbMRONMENTAL HEALTH DIVISION FILES <br /> t7,UNDER(IROUND TANK(UST)CLEANUP SITE(LOP) 0 HQUSWO AaATEUXNT BOND WASTE FACILITY <br /> 18r OTHER CILE HUP SITE(NON4-OP) O FOODFAC1LM rS.f'SOLVSWASTEVKHrCk.E <br /> rYrNDERGROUND TANK 0AONfToRwWREmovAL) Q DOG KENNEL 0 DAIRY <br /> AZAT�DOUS WA9T9 01ENERA70R O CKE <br /> CHIN RANCH 0 PK(STREATIMENYP.1_ANT <br /> TIERED PIERNAITTSD FACILITY ❑ MOTEIMOTEL O PUMM11TRUCKNAROTCHLUTOILETS <br /> 0 TATTOOreODY PEIRCWG O POOL/SPA 0 LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILrTY 4 PUSl1C WAVER SYSTEM 0 OTHER(PLiAbasPEGiFY A8OYq <br /> I. List up to tan addre;sus-In the Space above. Select the type(*)of files from the list above by checking <br /> the appropriate box(as). At toast one filo type MU$T be aelo&md. Fax to f20g) 4B4-0J3G 0r rnail to the <br /> address Indicated sbovli. <br /> 2. END will notify the applicant If any END filos exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10) days after receipt of application. The files <br /> will be held for a maximum of five buslnes{days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that Is actively being worked on by END staff may not be trllmediately,available for revloW. A naw <br /> application may be submitted when the file Is available. <br /> 4. Any file not returned In the same condition as released will be reorganized by END staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a $87.00 deposit prior to review. <br /> 5. "TENTATIVE appointment dates must be confirmed with END staff. <br /> 6. Applications received after 3:00 pm will be processed the Mart business day. <br /> c <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> 1 <br />