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Lt:J..W..uwL_I,11 <br /> SAN '-0AQUIN,C0UNTYPUDLIC HEALTH -�RVICES <br /> ol�` N%.,,,ENV1RQNMENTAL HEALTH DMS.,��l <br /> - 304 EAST WEHER AVENUE,THIRD FLOOR _ <br /> •STOCKTON CA 952D2 tr y 9 <br /> J U L 1 (209) 468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> m Log, BUSINF=AGENCr •f witC+P <br /> ADDRESS -- <br /> PHONE RQ �_ FAGSIMiIE� T LO �y�_L1S� <br /> TENTATIVE'APPOINTPA15NT I)ATI_ TIME -- <br /> (Pleass give 7 to 14 butina6r,days from data of application submitter{) <br /> 6ewiT25- 3; �L <br /> CHECK BOX TO EXPEDITE ill=QUE$l-$7 0 FEE—R [JEST PROCFS Ep IN 3 BUSINESS PAY5 <br /> SIGNATURE OF APPLICANT �- UATE J f� � <br /> FILE ADDRESS <br /> v�o 35a <br /> CID <br /> S <br /> zsay <br /> Y �S <br /> 3s,2� w <br /> v <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE.(LOP) M HOUSING ABATEMENT E7 SCUD WASTE FACILITY <br /> orkiER CLEMUP SITE(NON4.OP) ❑ FOOD FACILITY 0 SOLID WASTE VEHICLE <br /> UNDERGROUND TANK IMONITORINGIIMEMOVAL) CI DOG KENNEL 0 DAIRY <br /> FSAZAROOUS WASTE GENFRATOR 0 CHICKEN RANCH M PKG TREATMENT PLANT <br /> Cl TIERED PERMITTED FACILM ❑ MUTELIHOTEL M PUMPER TRUCK/YARDICHEMTOILETS <br /> 13 TATTOOIBODY PEIRCJNIG 0 POWSPA CI LAND USE APPLIGATION SITES <br /> MEOW.ALWASTE FACILITY a PIJULIC WATER SYSTEIN M OTHER(PLEASE.SPECIFY ABOVE) <br /> !. List up to ten addresses in the space above. Select the type,)of files from the list above by checking <br /> the appropriate bwges). At least one fila type MUST be selected. EM t4 (2,09)464.0138 or mail to the <br /> address i"dicateo,above. <br /> Z. ivHD will notify the applicant if any EHD files exist. An appolAtmont for review will he confirmed <br /> approximately five business days but no later than ten(10) days after receipt of application_ The files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by l*HO staff may not be immedlately available for review. A new <br /> applicration may be submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will tw rearganized by EHP staff at the expense <br /> of the applicant. Future'-file reviews by the same applicant may require a$78.(10 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with END staff. <br /> 6. Applications received atter 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE _ TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YlrS NO REVIEW DATE - <br /> 54 rA 14 0IMSDO <br />