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Tu a �r rtx�rit.ji r .a�� <br /> SAN *QUiN COUAt'rYPUBLIC HEALTH S�ViCES <br /> ENVIAONMENTAL HEALTH DIVISION <br /> • <br /> -304 EAST WEBER AVENUE,l UPWI FLOOFt <br /> • STOCKTON CA M02 <br /> FUSER RECORDS RELEASE APPLICATION <br /> ' ?aPPUFmT <br /> L1/,,,,��••�� t3t1SWESSIAGFA1C1ri�����'�( j �--•��r�.}� <br /> L L <br /> FHBNt;�a+�L a (e>-`.��.r�1ms Fac$IMtLE e <br /> Glo <br /> THHTA"nVE APPO1",rNkcNrWrE <br /> • {P�eada pine 7!�7C bvsrsoss days�.,�date of�pPuaatfOrl i1tMtiAi+1 <br /> CHgCx sox ro a rre=�auE ' AOFW- <br /> 3T PROCESS=1r►s r;uslntRss DAYS <br /> SlGN11TtJRE OF APPLICANTMP <br /> - DATEi <br /> ALt:ADDRESS No am IMRMAm un ONLY <br /> 4 PNgGRAN CLMENT$3CARCH <br /> -7 tr Aft <br /> • •�- <br /> C <br /> ' G <br /> 1 7' D <br /> ENlV)RON1MENrTAL HEALTH DivisioN Meg <br /> IMUCRGROUNU TAMC(Lm'r)CLEANU�Srm(LOP) O mousm ApATOAENTNUSOLD WASTE FAMJTY <br /> fflFtER <br /> CLEANUP JrN p40H4.0P) a FCOO NArnJW OLJD WAWH VEK1CL8 <br /> Ul9DP.ftrmtoum TANK Y410 ITCQR(kG(F�Bt�IOYA.L.) a DQG KENNEL. E3 DAM <br /> NAZAIWM9 WASTE GENERATOR s Q CHiCMEN RI CH D rKG TREAIMENTPLANY <br /> ncRso raRrart'rrin FACtuiY ' o MOTEaLmOTEL o-PL4W=TRUCMAROX NEM JOLET8 <br /> C;TAYTOOSODY Tar'rI ONG i 17 P001►SPA O LAND USKAPPLJCAT"SHRs <br /> Q MEDLCAl-WASTIE FAC1LMY 0 PUB=WATER$Y&TEM O OT R VK.E^SH$PEC1FYA90%Q <br /> �. Ust up to ten addrarmes In the spaco 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 Rax to 2")464-i7938 4r mad to tho <br /> m ingirmtedab v <br /> ?- <br /> END will notify the applidant if any END files exist, An appointment for review'inrill be confirmed <br /> • approximately fire busL*=days but no later than tan(10)clays alb receipt of appilcation.•Tlw files <br /> will be field for a maxlmurn of five burriness days for review. Appointments should be si.hgdulmt <br /> accordingly. <br /> 3- A Fla that is RGUValy beir<g•vrorkad on by FKD staff My not be)mmadlat6ly available for reveww. A new <br /> application may bm aubrd Med when the file is avaltable, <br /> a. s+ny file not returned in too same condition as releasod will be rearganbwd by EM staff attfte expens& <br /> of the applicant Future1lie reviews by ttte aaDze a0l�t MY rogairo a S117A0 deposlt prior to mview. <br /> S. 'TENTATIVE appointme l dates must be cuam med with END staff_ <br /> 6. ApplicaAans received afJor 3�0 pm will be processed the nwd business day. <br /> T <br /> 1 <br /> ONFRRMED AnpOINTMENT DATE ITIME <br /> ATECONFIRMED PHONE FAX IHMALa �-` <br /> $WfEp YES NO RMEW DATE <br /> Nam VA� <br /> TUrPL. P.M <br />