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04-16-2601 06:51AM TO + 19254409632 P.01 <br /> era voce nuw�w <br /> SARI JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DPA=N `,j Z(o <br /> j 304 EAST WEER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> (209)488.3420 PAY 3 0 2001 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANTuFL N�iT� GOiyST/1.UTYN BuaNEesrAOEi+cr GE�GO,V Cd�S[� % � il�S',�/ Sih <br /> ADDRESS -e73 w LijS AofiTgS ,aGyDj STi'2y.5-' <br /> PHONE 3 z. FACSIMILE/ 52- S- 9'lO - 963 2 <br /> i TENTATIVE`APPODITMPIT DATE �/ TIME <br /> (PI&S"alw 7 w io bole-er"-days Nvm WN vl appucauon sabmitW) <br /> 4/,r'//Ts a, 3, <br /> ! ❑ CHECK BOX TO EXPED"REQucsT-sa7.00 FEE-REQUEST PA ED W S BUSINESS DAYS <br /> SIGNATURE OF APPLICANT 2 n t/y^C' j — 1 DATE f <br /> F ADDRESS THIS SIDE fiHO aT F USE ONLY <br /> PROGRAM ELEMENTS SPAR" <br /> Sea r 1T, STO0 k ro <br /> 0A-7-C-, <br /> 312e c p — <br /> 6 $OVT ST. Ta c tTt� <br /> 2 . C TE Wh_Y Wily. 5 O c YV -7 <br /> !Ta R Oc O 3S•aG <br /> DO > Lj6frnf S�, rAGf7f7N - G <br /> i <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> ! r1�DERoROUNU TANK(UST)CLEANUP SITE(LOP) C3HOUS040 ABATEMENT 6y50LID WASTE PACILITY <br /> [Y OTHER CL.PAXUP SITE("ON-LOP) O FOOD FACILITY e8OU6WASTE YGHICLE <br /> ! � NOERORouNp TANTS(wmrTO9WWkEMOYAL) Q DOG KENNEL El DAIRY <br /> DOU3 WA3TR GENERATOR O CHKaCHN RANCH O PXG TREATMENT PLANT <br /> { T1i Rtar PeAUMEO FACUJTY O IaoTELMOT21- 0 PUMPER TRU CKIYARDICKL I TOILM <br /> ❑ TATTOOMODY PEIRCING ❑ POOL%SPA O LANO USE APftXATiON SUES <br /> ❑ MEDICAL WASTE FACILITY ❑ PU0AJC WATER UYSTEM tl OTHER(PLEASE SPECIFY ASOVEI <br /> 1. List up to ten addrs;sus-in the space above. Select 1hs type(*)of rites from the Iist above by checWng <br /> the appropriate box(as). At least one file type MUST be setectad. Fax to 1204)484.013((er m 1 to the <br /> address Indicated aoove, <br /> 2. EHD will notify the applicant N any EHD files 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 hold for a maximum of five buslnes4 days for review. Appofntments should be schedulad <br /> accordingly. <br /> 3. A file that Is actively being worked on by F.HD staff may not be Immediately available for review. A new <br /> application may be submitted when the fas is available. <br /> q. 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 conf4mad with EHD staff. <br /> 6. Applications recsivid after 3:00 pet will be processed the next business day. <br /> i - <br /> FGATE <br /> NFIRMED APPOINTMENT DATE TIME <br /> I CONFIRMED PHONE FAX INITIALS <br /> I <br />