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SAN JO IN COUNTYPUBLIC, HLALIh Z�t_KVII;tz,-j <br /> .1 1 H DIVISION F� j]RONMENTAL HEALT <br /> StIg EAST 1VE13ER AVENUE,THIRD FLOOR <br /> / ' <br /> STOCKTON CA 952132 <br /> (209) 468-3420 <br /> ".4 <br /> PUBLIC RECORDS RELF-ASE APPLICATION <br /> r <br /> APPLICANT C CA*,njoy� A <br /> o ::c "JI <br /> ADDRE.S.S Skc e+ _Sovno Y�-2L, CA CD LLI C-,) <br /> PKON9 <br /> TENTATIVE"APPOINTMENT DATE TIME 10 0 <br /> (Please give T to to business days froM date of 2pplicition%Lbmittal) <br /> c::c cc: <br /> LLj <br /> E31/cHECK BOX TO EXPEOME REQUEST-387.00 FEE-REQUEST PROCESSIED IN 3 SUSIXESSDAYS EDE <br /> SIGNATURE OF APPLICANT DATE - 2 <br /> FtLE ADDRESS 1 THIS SIDE:EMI}STAFF USE ONLY <br /> PROGRAM ELEMENTS SEARCH <br /> A&840G> 501 l + r4-*ttr,'%an <br /> WtG+ <br /> 4-0 <br /> -------------- <br /> FENVIRONMENTAL HEALTH DIVISION FILES; <br /> �/uNoERGROLNO TANK JUST)r_L4ANV'P SITE(LOP) C] HOUSING ABATEMEKr 0 SOLID WASTIE FA CILITY <br /> z' OTHER CLEANUP SITE(NON-LOP) 0 FOOD FACILITY L3 SOLID WASTE VEHICLE <br /> C3 VNDERGROUND TANK(MONITORM011EMOVAL) C3 COG KZNNEL CI DAIRY <br /> HAZARDOUS WASTE GET4EPATOR. 0 CHICKEN RANCH C PKG TREATMENT PLANT <br /> 13 TIERED PEFUdr1-TZ0 FACILITY 0 MOTELtHOTEL 0 PUMPER TRUCYjYARzir_mFMrO1LE-TS <br /> 0 TATTOOIBODY PEIRCING 0 POOLiSPA M LAN M USE APPLICATION SI-TES <br /> fl M rt.DICAL WASTE FACILITY C] PUBLIC WATER SYSTEM 0 OTHER(PLEASE UPECIFY A13OVr,,) <br /> 1. List up to ten addresses in the space above. Select the type(s):kof files frorn the list above by checking <br /> the appropriate box(es). At least.one file type MUST be selected. Fax4o (209)464-CIU ior M I to the <br /> addrgns indicated Ah9ve. <br /> 2. rzHD will notify the applicant if any END files eXist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten (10)dayis after IreCeipt of application. The files <br /> Will be held for a maximum of Five business days for review. Appointments' " ShoUlej be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked an by EHD staff may not be immediately available for review. A now <br /> application may be submitted When the file is available,. <br /> 1 .1 <br /> 4. Any file next returned in the same condition as released Will be YaOrgariized by EHD staff at the expense <br /> of the applicant. Future tile reviews by the Sartre applicant rn2y'e uir�a 387.00 deposit prior to review. <br /> 5. *TENTATIVE appointment dates must be confirmed with JEHD <br /> stlaff� <br /> 6. Applicaticns received after 3:00 pm will be processed the next t5usin6s:'s day. <br /> CONFIRMED APPOINTMENT DATE TIME I <br /> DATE 60NIFIAMED PHONE FAX INMALS <br /> REVIEWED YES NO <br /> IN 012 1&arAm7mh REVIEW DATE <br /> TOTAL P.01 <br />