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y!+u.i.i_LtJUU i-Oi-A I. iAIH1PAa ' -IJ;J, li'{:_. ��'J �:�_i 11LU ii—l., _,'1 _UU I .I��Jl' •LIy <br /> 08-14-2008 10:29pN F� TO 155926871,26 P.01 <br /> aAF.t�P`tAG MUMYCR <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> FWD <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304EAST WEBER AVENUE,THIRD FLOOR Z,3 I <br /> Aug 1 2000 STOCKTON CA 95202 <br /> ENZ HEALZH (209)468-3420 <br /> EtWPLMPUBLIC RECORDS RELEASE APPLICATION <br /> PEFi�cANT �si4 <br /> I7t fIUSWC53lAGENCY <br /> I <br /> ADDRESS ) (� <br /> PHONE 7 'A) FAC3tMILE L.0 9 �l .p <br /> 1 <br /> I <br /> TENTATIVE"AF'POINTIAt NC!AATE Pv�r4 a TIME — _�>. <br /> (Please give 7 to 10 buai snA s days from date of eppllcauon submittal) <br /> QCHICK 6OX TO EXPEOM REQUEST 487.00 FEE-REQUEST PROCZSSEO IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT- _ DATE <br /> / 1 FAQ ADDRESS THIS SIOIE END STAFF USE ONLY <br /> v35 k ro Kcxf_ PF(OGRAIW ELEMENTS SEARM <br /> eco21�12 1 D <br /> 0 2 �. <br /> �o C DJ o S t Ar. ami <br /> 35-K4 VA o <br /> D -��j 6:1,0 �3 cq,. -a� <br /> I ENVIRONMENTAL HEALTH DIMION FILES <br /> UXOERGROUNO TANX(UST) CLEANUP SITM(LOP) ❑ HOUSING ARAYEMENT ❑ SOLID WASTE FACUI`f <br /> OTIIER CLEANUP SITE(NON4-OP) Cl FOOD VACILM 0 SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(6lO NWORINCiI EMOVAL) ❑ DOG KENNEL Cl DAIRY <br /> .�C HAZAVWQUS WASTE GENERATOR Ct CMCKEN RANCH O PKG TREATMENT PLANT <br /> P TIERED PERMtiTEgFACILIFY 0 IdareLIHOTEL 0 PUMPER TRUCKITARWCHENITOCLM <br /> P TATfO=ODY PEIRCING d p60LISPA ❑ LAND USE APPLICATION$1TES <br /> ❑ AtWiCAL WAM FACILITY la DUBLIG WATER SYSTEM ❑ OTHER(PLEA39 SPECIFYAHOYI24 <br /> t <br /> 171. List Up to ten addresses in the space above. Select tha type(s)of fllf*from the fist above by checking <br /> the appropriate boxes). At least one Fife type MUST be selected, to2rA 138 or mail to the <br /> address lntiicA ed gbove_ <br /> 2. END will notify the applicant if any EHE?files exist. An appointment for review will be confirmed <br /> i approximately five business days but no later than ten(10)days atter receipt of application. The files <br /> I will be held for a maximum of five boniness days for review. AppointTitents should be scheduled <br /> accordingly. <br /> A file that is aCtively bcing worKed on by EHD$U f may not be irnmadiately available for review. A new <br /> application may be submitted when the file is evallablo. <br /> 4. Any file not returned In the same condition as raleased will be reorgartixad by EHD staff at the expense <br /> of the applicant. Futura file reviews by the came applicant may require a$87.00 deposit prior to(OWAW, <br /> �. "TENTATIVE appoin went dates must be confirmed with ENO staff. <br /> �5. Applications received aft*r 3;00 pm will be processed the next business.day. <br /> i <br /> CONFIRMED APPOINTMENT DATE TIME <br /> PATE CORFIRMED PHONE FAX INITIALS <br /> F ' <br /> t <br /> REVIEZWED YES NO REVIEW DATE <br /> TOTAL P.01 <br />