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FROM : NOA Environmental PHONE NO. : 209 369 4228 • Feb. 06 2002 10:33RM P1 <br /> S N ,10ACUIN COUNTYPUBUC liEALTH SERVICES <br /> 7 ENVIRONMENTALHLJ1L-M DIVISION <br /> ii�'11CF 304 UA$T"611ER AVENUE.THIRD FLOOR <br /> STOCKTON CA➢o= <br /> 02 FEB -6 All 10' 42 (203)AUUU <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPuuxv %L- OlAowt euawrs3JAQM r MCI L 0• At-4nee-�N 4 A-5soG . <br /> A=U= z`L� t�1. ft U5 'DU LA9,3E t n Ey i Cfhg 5_J_4a <br /> P1tio1u ?zq-r3u 1- - 3"L O t FAcmrae 2.DG <br /> TEurATNE'APPOIKTMLaa&= )- ZJ t)Z Tum <br /> (PlurT�1 du.,�amm+.m.pp,kW,a.ubauiwl <br /> &l 3, <br /> � eaeat Dox To t�aoaa aecuasT. o Pr+r_....,...r iN a tLtltrotssa oAYs <br /> SIGNATURE OF APPLICANT - DAA <br /> P0.EAo01taai <br /> v 0 tee <br /> 0 2va 2z : w <br /> e✓d 4 F <br /> 1 <br /> ENVIRONMENTAL,HEALTH DIVISION F11.E3 <br /> 'IS UNUMitcuiM TMK IusT1 Ctsa+uP UM(LEE) O 40=10 A6iLTEllM G aW W W=M FACIlM <br /> oTKMCI2Ain1 ermInO -um O M=FACIiM M ZQ:.WWA3MVFnui& <br /> UN0IRMWUWDTAJ4KW011tTOita+elRIINOYA34 a OWKE ML CDAIRY <br /> NAZARDOnaYfAWMaZWEMTOn a C1110=RAMM D PKGTWAT&UWPLANT <br /> O TWt110RW0Xr EDPACLLF7 a NGn?LAjVnL a wyPmrTN=TAKW:H lT=XM <br /> a TATTOOBODYPa!K=W a PocuapA R LAr/DUUAPK=ATtoN=13 <br /> O U=Al WAIMFACIM IS PimL=VATt'RaYttM G on=(pLti<=W%CLFYAllQM <br /> 1. List up to tan address"In the space above, Sale=the type(&)of tiles from the list above by chacking <br /> the apptapriate box(ex)_ At loan one fila type MUST be eolectod. E M MO 464M38 or man to the <br /> seldrass Indicated above- <br /> 2. MIND will notify the appScant If arty END files extat. An appolmn,stufar rsviaw wilt ba confamod <br /> apprartmataiy five busilim days but no laferttian tan(10)days after reaeiptaf 2PPlI=tlon. T116111161 <br /> will behold tors maximum of fwa business days for review. Appointments should bo scheduled <br /> aocortUn*. <br /> 3. A fila that is natively being worked on by EHO atilt may not be Immediately available for ra law. A now <br /> 4. Any renunad I ORM9 condition as r11aau d Will he marganixad by MID staff At the expense <br /> cf the appticaht Future fila reviews try no Syne applicant may r6quim a S=Q deposit prior to review. <br /> S "TENTATIVE appoinbnwd bates must bo car f mad With ERo Stan. <br /> { <br /> IL Applications recolvad attar 3;00 PM Wiu be processed the next businsas day. <br /> ICONFIRM® APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW oATE <br />