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i u6c�1v4tJ I WU LOG hUm d& <br /> f SAN .JO7CQUIN COUNTYPUBLIC HEALTH SIE CES <br /> f <br /> 1, _ <br /> ENVIRONMENTAL HEALTH Q1VISial�t (t <br /> j �U 304 EAST VY�OZR AYILNUE,THIRD FLOOR I <br /> ST'OCKTON CA 93202 }{ b 1-.;����� <br /> C 1209) 8-3420 <br /> PUBLIC,RECORDS RELEASE APPLICATION <br /> RUSIFIE8S1AGL1lGY <br /> oz000 <br /> APRicArIT J; <br /> qj f'EALTH <br /> AADRt:S3 <br /> F�7VICES <br /> PHONE FACSIMILE <br /> TErsl'CA'TI1fE"APAWNTMad(+IT pATI! 06 I.�l'IFeE �� t CY) y'% <br /> I,I (Plaase eve 7 to 74#iisir&ss days Crum due of appiWAIgn sutomlt#al) <br /> CHECK SOX TO GOITS R>=Qu0T-$79.00 FEE—RCC t P FiSRED ITs s BUsI> S 1�l�Ym <br /> SIGNATURE OF APPUCANT DATE <br /> � a1 <br /> FILE ADDRESS 'f THIS SAI FJ{>p STAFF U E b LY <br /> P"4RA9 E1_AfflV 3$9ARC1 <br /> t kl. 3 <br /> it <br /> eNVIR0NMI:NTAL.HEALTH DIVISION FILES <br /> UNDERGROUND-rANK(UST)CLEA14UP SITE ILOP) [7 HOUSING ASA'r9M4NT Ca! 3QUD WA57E>:ACILITY <br /> OTHER CLCAN[iP SITE CNt}M-OP] <br /> G FOOD FAC LRY 'I IM! BDIJ4 WA VEMCLE <br /> {� <br /> IlNDURGKOUND Tank(M0K1TVRtNGF-5MQVAL) L3 DOG l4.I+1N'liL of DAIRY <br /> HAZAR,DOW VVPATF.QMNEMTOR CI CM11CKkK RANCK �i C] IPK0 TSREATMENT PLANT <br /> saoT'LiL <br /> I'1 TtQR20 VZRmn-MO FACILITY 0 UOTRL �' 121, PU -nWGrJYARWCKM TQ LC'T4 <br /> 0 TATTOOMOQY PI IRCING 0 P00Llt9PA G LAND USE APPLICATION SUES <br /> 0 MIDLCAL.WASTE PACIILrft 0 PUBLIC WATER SYSTEM I G, OTHEfL WLF-&Ag 1iPEGjFY ABOVF-L <br /> 1. List up to ten address"in the Space above. Select thea type(4)of filar.from the Ilst above by checking <br /> the appropriate box(es). At least arse Ilia type mu s-r be seimted x to 7 B or mail 1;2 th <br /> agateaA Indicated above. <br /> ZKV wlli noM the applicant If Any ZHiD Wets exist. An apiaairitrTlenttor review wlil be confirmed <br /> approximately flYe businm slays but ria Igter than teen(10)digs alter recolpt of appliaeVon. The files <br /> w11I be held for a ma%Murn of fivo bUaiiriEsg flays tar review. .4poiritments should be scheduled <br /> accoAfire that Is <br /> s of be immedlale! available for review. A new <br /> 3. A f1[s that is aotival�r being vsrorkeaq q17 by ENI]stall may i1 y <br /> application may be submitted when the file Is available. it <br /> 4. Ally Ili*glut mtumed In ttse same coni Mtlon as relMetl WAI bP reorga nited by CHD"fait at the expertse <br /> rev a same ilcatnt Ina re d1re a$78.00 de alt prior to review. <br /> of the applicant. Future file laws by the app Y 9 I pQS. "TENTATIVE uppoinUnent Batas must be 000firmed with I;tr31t.$, Applications received atter 3:00 prn will be processed the next bus�ass flay. <br /> �r '4 <br /> �f <br /> �a <br /> CONFIRMED APPOINTMEWT DATE TIME <br /> i <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW RATE <br /> LW Va 14 OW4W ' ILlIHL F'.Iu <br /> i <br /> ` I� <br />