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Lj A_ tL'J: <br /> kid <br /> SAN JQAQUL.N COUNTYPUBLIC HEALTH SERVICES <br /> df ENVIRONMENTAL VJ <br /> , ONMENTAL HEALTH 01VI-510N-- f 304 EAST WEBER AVENUE, MiRD FLOOR <br /> STOCKTON CA 95202 <br /> (200)463-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPL!CAN r --Erd )Jew"I na BUSIf4ESSIAGENCY <br /> e)l-)d Au <br /> IILE <br /> TENTATIVE'APPOINTMENT DATE TIMZ <br /> (Pfigasmgiv':7 <br /> CHEOK BOX 10 LXPEOITE: <br /> 3 BLISINE$$0AYS <br /> SIGNATURE OF Ai:PLICANT DATE /4';'-0 <br /> 1=.L-5 Al)i�RE 1-5 THIS 5 It)E,F H 0 STAFF USE QNLY <br /> J, PROGRAM ELLMLNTS 5EARCH <br /> —7- <br /> 7— S <br /> ai- <br /> I 7?C <br /> �dJ SILAz'--elp- <br /> ENVJRONMENTAL HEALTH DIV1510N FiLl�$ <br /> �N0!;rXURP'j-'W WST)CLLA&W[�- HCtJSiNQABATEXElA7 � SOLID WAS-5 E PAC.IUT'y <br /> 'FHER CLEA-NUP SITE jMQ.hJ-LOP) u FOOD FACIL.':TY' G SOLID WASTE vEwct-r- <br /> TANK 17; DOG KC-NNO. C3 DAIRY-7KHAZARDOUS WASTr=0SNEq1TOR CHICKEN RANC11 0 PKK I REA-MEN7. PLANT <br /> TIERED PEPM17TF-o fA(;JLITY -=1 MOTEUHQTE« C-5 F LIMPF P TRZJCKryARDjC"EM Tott E-TS <br /> T-NT",00150DYP=IRC'-%C- J POOL".5PA " - 0 LAND USCAPPUCATION srtEs <br /> 6%ZrjrCA.1,WASTE FACILITY PUSLK;WATER SYSTEM, 0 0".14F-R(PLEAEF sPrri rVABOVE) <br /> 1. List up to ',en addresses :r the spzaa above, $ofe(n the type(s) of files from the list above by checking <br /> the appropriatebox(ez). Atleast aria file type MUST be selected. Faxto (2 9 464 (>r!]jail t C the <br /> address indicated zbove- <br /> 2. END will notify the applIcant if any EMD tiles <br /> exist An appointment for review will be confirmed <br /> approximately five days but no later than ton (10)days after receipt Of application. The files <br /> -6vill be hold for a MaXim'Jnl Of five 13113incss cfay.% for review. Appointments should be scha'dulad <br /> accordingly. <br /> 3. file that is actively being worked on by EHO staff n.1;3y not ba-hnMedii]MY availabie torreview. A new <br /> applica.'ion may be zubmfttod whan the file is <br /> ,a. Any filch not returned in the same condition as released will be reorganized Uy L EHD starf at tfte expense <br /> of the applicant. FutiAre (jlL- revieeys by VIQ same applicant may reqL4ii,e a$57J)0 dePOSIZ prior to review. <br /> 5. 'TENTATiVE appointnier.t dates must be confirmedwiti, EKD staff, <br /> 6. Applications received after 3.00 pm will be processed the next business day. <br /> CONFIRMED APPOiNTMENT DATE TIME <br /> DATE CONFIRMED PHCJN� FAX Wrl-LALS <br /> REVIEWED YES NO REVIEW DATE <br /> Bpi 04 A.; 41A.v7(R4 <br /> TOTi-L P.01 <br />