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ti SAttii '"CNV RONMENTAL H LTH�VIStaVIG" <br /> Xg FAST WEBER AVENUE,THIRD FLOOR <br /> t1V vqz STOCKTON CA 95202` Q <br /> (200)4W3420 <br /> M alAP' P BLIC RECORDS RELEASE APPUCAT ION <br /> J'A� jU111AJ AW CA <br /> sus�r sr rc + t I <br /> A1C. <br /> 1:1 H 0 71:j FACSmnx--L&iJ W4 1 <br /> TENTATIVEw APP011471IENT DATE --('s TIME S 0 Q gua <br /> (Pka glvs 7 to 10busi teas days from Gate of apprwAdan It <br /> 1 rtmcx zoo T4i omEDrm RewjEn7a EE � <br /> EST PRflSSIED IN 3 DUMP-$$DAYS <br /> 1 <br /> SIGNATUREOFAPPLICAf5T ��# - � DATE �00- <br /> - .7 <br /> L60:2 S <br /> Q'3 1 L . <br /> A <br /> ENVIRONMENTAL HEALTH DIVISION FILE$ <br /> UNDERC#ROUND TANK(UST)CLEANUP SITE fL 4* C3 Bios NCs AbA1rEt+trzW M SOLID WASTE FACLVIY <br /> OTHER CLEANUP WM(Fi{ N4A)P) 0 FMD FACIL.CtY 13 SOLA]WAWEVWKX <br /> M UNDE"ROURD TANK IMONITORINGIREMOVAL1 ❑ DOrj KENNEL. M DAIRY <br /> M HAZARDOUS WASTE GENERATOR t3 CHKMN RANCH C3 PKe'MEATMENTPLANT <br /> d TIERED PERUff TED FACILM C7 MOTEL)HOTEL. 0 PUMPER 7RUCKNARMHEM T ORXTS <br /> 0 TATTOOSODYPEA1ilt:'f 0 C3 POOL03PA C LAID USE APPLICATION SM <br /> C3 MEDICAL WAVM FACOAY 0 PUBLIC WATER SYSTEM 0 OTHER".15ASESPO YASOVS) <br /> 1. Last up to ten addresses in the aspaco above. Select the types)of fi€e$flan the lest aba ve by ahecldne <br /> the sppropriafe baa gers). At least one file type MUSS'be sole d Fax tom.{ )464-0138 or mail to tti1� <br /> res 1r�dfcat above. • <br /> Z iMvill notify the applicant if any E D this eslst An akppointrnent for raview drill bo cafTfirmed <br /> appreodrsis ly f ftibtlsinese Mays but no 1star than ten(70)days after receipt of apprMftn. The 610s <br /> will be hold for a Maximum of five business days for review. Appointments should be schedubd <br /> a lcc"ngly.; <br /> 3. A flies that Is actively being wo*ed on by END staff may not be Immediately available for rovlew A now <br /> appocadan may be ssabMIft*d when the file is available. <br /> 4. Any file Clot returned In the same condition as released-will be reorganized by END staff at the expense <br /> of the;applkint. Future ft reviews by thk same applicant may requirer:a$7$.00 d"sit prior In resv ow. <br /> S. <br /> *TENTATIVE appointment dates must be aonf need with END staff. <br /> 6: Ap,0111 s4tl"::nscelved after 3:00 prrl w311 be processed the next business day. <br /> CONF1RMEa.APPOINTIAENT DATE. TIME <br /> DATE CONFIRMED PHONE FAX INfTOALS <br /> REVIEWED YES .. NO REVIEW BATE <br /> M=u own" <br />