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aKo ioe suaesH <br /> J1 <br /> f> . . .�RECEP COUNTYPUSLIC <br /> �jICES <br /> NVNTALHEL HDIV 30 h <br /> 304 FAVINFRERAVENMTHIRDFLOOR �� p <br /> APR 0 7 2003 STOCKTON OA 95x02 h <br /> (2009)469-U20 j <br /> ENVIRONMENT P&MUC RECORDS RELEASE APPLICATION <br /> APPLICANT ! ,• e L 9USMEt:SIAOENIY <br /> ADDREsrs` 5»0 (a�s>`. S � D��+.„••t ,c,4- �� <br /> NONEyrOl�9h' �6a0 FAC31MILEAWA, <br /> TENTAI'IVE•APPDMTMENTDATE sSsoonAs�o t6/+' THE SAlT:A- A5 �r,i.n t[?thRL.✓s I^ 5 <br /> tPka"vivo 7 m 10 buel�am nate off appuaow submnlal) �ZU/t/✓ I[j. 3 'E / <br /> e ! <br /> CHECK BOX TO EXPEDITE REQUEST.S59.00 GEE-REQUEST pROCE53E0 IN 39USalE38 DAYS , <br /> )4 SIGNATURE Or APPLICANT A A �f[Z OAT <br /> i <br /> IL <br /> � <br /> a1D6 END STAFF USE ONL <br /> FU.E ADDRESS PROGRAM E460MENTS SEARCH <br /> t � <br /> J <br /> — III 1 <br /> ENVIRONMENTAL HEALTH DMStON FILES I <br /> l - 7 HOUSING pBATOalNT O DO SOUOWASTEFACILrfY- I <br /> a UNDERGROUNUTIWK CUI CI.IJJIUP SITE(LOP) O FOOD FACILITY CLIDWASTEVEHICLE <br /> - <br /> C) DAIRY <br /> O o-mz;t CLEANUP IR E ISNE3DOG KENNEL t3 KDP'Kc.7REATIAENr PLANT � <br /> O UNDERGROUNO T/WK@IUNITDRWGIR�MOVAL) ❑ CHICKEN RANCH t3 PUMPER TREARUCKfYARUICHEN TOILETS 'I <br /> i ❑ HAZARDO M Wti fE oEwRATOR ❑ MOTEUNOTM O LAND USE APPLICATION SITHS <br /> ❑ TIERED pERMn•M--D FACILITY O POOVSPA <br /> M TATTOOMODY PORCD3G, ❑ OTHER(PLEASE SPECIFY AROVE <br /> the) ! , <br /> G MEDICAL WASTE FACILITY spacD� s of files from the list above by checking <br /> t t.fat up to tan addresses in the e above. Select the typo{ ) „08) 139 or mall to the <br /> the appmpriaty boXJes). At isast or»file typo MUST be selected. F y <br /> atldre sllindieall e?ove• oinfmollt for rovl¢W will be eennrmed <br /> _ 2 EHO vvi9 nobly tlw apWl�t N any EHD files exist An appn. <br /> approximately iNe business days but no later than tan(1D)days after reuspihouldpba sscheduled files <br /> will beheld tot a ma,Ximum of Siva budness days fol review. APPa�I I,i <br /> accordingiy. EHD staff may not be inTmedtately available for review• A new;{ r <br /> 3. A fife that is activ�elymC wttan tht�e is avo(labie. t the <br /> Any tale no may <br /> q. Any fila net returned in the same condi the same applicant tmay requiretaa 599.00 depoa Porto review) <br /> of the applicant. Future filo reviews by <br /> 5• *TENTATIVE appointment dates must be Oenfirmsd with EHD staff- <br /> 8. APPII'ations rece;vrd after 3:00 pm will be Processed the nett Dusinets day. <br /> I T1ME <br /> l CONFIRMED APPOINTN1EtiT DATE <br /> PHONE FAX INISIALS <br /> �I GATE CONFIRMED I'r <br /> .fig - NO REVIEW DATE <br /> REVIEWED <br /> nm <br /> j <br /> iI <br /> ] ON XFid <br /> W021d <br /> £d WU60:01 2002 L0 'add <br /> ii <br />