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04-16-2001 0B:51AM W TD. 19259409632 P.01 <br /> vn ILL MtCWYoD f1+0 L(XW Ml1WWt <br /> SARI JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION r 5Z (o <br /> j 304 EAST WMER AVENU E,THIRD FLOOR <br /> STOCKTON CA 98202 <br /> (209)4684i20 +'?IY 3 C 2001 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> AAP..ANYrALft4f1Y C0#57',1Xf7+141 BU&NR3-WA6ENCY GEOCOAI CO NS�/G/i�9�TS <br /> i <br /> ADORE- <br /> PHONE 9�.5_ 9S(o ' 96 P. PAOS,mLe/ <br /> TENTATWE'APPOINTMR.NTDATE / �/ TIME !�q <br /> (Pia�plVa 7 w le bus' dauiea�rs Irom data at aposauon subenittsi) <br /> 6&//TS --:2, 3, #- <br /> ! Q CHECK BOX TO EXPt__DRP REQUE3T-b37.D4 FEE-REQUEST PREO_,"3 BUSIRM DAYS <br /> SIGNATURE OF APPLICANT � 2 � �� (4A, 1 DATE S <br /> F"ADDRESS THIS SIDE SHO STAFF usd ONLY <br /> FROORAM ELEMENTSSEARCH <br /> aur $r. 57'ocATo <br /> IC03 500 ST 7_47C xTty <br /> Spa c TO X <br /> o lr-. r eer" <br /> R ITe R Oc Q 3SaG <br /> S_ DJA o dCkTC'J/j <br /> IT <br /> DD L toc pG d �1G <br /> i <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> t'! DEROROQND TANK(LIST)CLEANUP SITE(LOP) ❑ IIOUSOM AEATFM:atT INI�FQLIO WA.BTE FACILITY <br /> IYOTKER t.l_",iUP SITE(NON-LOP) O FOOD FACILITY esOLID WASTE VEHIC" <br /> ��l7110EROROUNP YANK(MONTTOfxINW EMOVAL) P OOG KENNEL ❑ MRY <br /> ¢7,HATJUTDOUS WA-9TG GENERATOR ❑ CHICKEN RANCH O PXG TREATMENT PLANT <br /> j ldlff Tl RED PBRMITTeD FACUJ" ❑ NOTEUNOTEL O PUMPERTRUCK(YARDKHWATOILETS <br /> O TATTOMODY PEIRCtNG O POOL/SPA ❑ LAND USE APPLICATION SREa <br /> ❑ MEDICAL WASTE FACILITY ❑ PUBUC WATER SYSTEM ❑ OYHER(PLFASBSPL'CIFY ABOVq <br /> 1. List up to tan addresses-In the space abova. Select the types)of Was from the list above by checking <br /> the appropriate box("). At least one file type MUST be selected. Fax to NOR) 404-0131 or mall to the <br /> address Indicated apovo. <br /> Z EHD will notify the applicant H any EHD fiiea exist. An appointment for review will be confirmed <br /> approximately five business days but no later than tan(10) days after receipt of application. The flies <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 bein0 worked on by EHD staff may not be immediately available for review. A new <br /> application may be submitted wtwn the file Is available. <br /> ! 4. Any file not returned In the same condition as roleued will be rsoroantzed 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 EHD staff. <br /> 6. Applications recelv+d after 3:00 pm will be processed the next business day. <br /> c <br /> CONFIRMED APPOINTMENT DATE TIME <br /> i DATE CONFIRMED PHONE FAX INITIALS <br />