Laserfiche WebLink
_Y-'I._ ._�_.._ �� __•-fir 1 . <br /> .;=1�N'�Lia:J:i} kHt:iw i+umuLu <br /> SAlti .!©A�UIN COUNTYPUBLV- HE <br /> ALTH SERVICES <br /> = ENVIRONMENTAL HEALTH DIVISION <br /> APR — 5 2��1 � ' <br /> 344 EAST WEBER AVENUE.THIRD FLOOR <br /> STOCKTON CA 95202 <br /> (249)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> A?P(_ICA - , '1 ( LL a r3 P�f SU$INE$51AGEIdCY <br /> PM6} t fC '1 �� '?i � T . ��C�FACSIMLE X 53 ) R3� <br /> TEN'rATiVE-APPOINTBrI�IVT DATE t �d�.t r�br l �]i�EA <br /> lVI[�Se yTlrc 7 to'ifl busn' Clays$o d�S*2 Pf 2ipp�otian gubm(tent? <br /> CiicCK BOX TO EXPEDITE ftEQUEST-5a7-00 ME-REQUEST PROCESSED 1H 3 Ul15iN[EsS O.+YS <br /> SIGNATURE OF APPLICANT �a vz^ti f�� DATE � <br /> Pit ADDl2E55 THIS SIDE ERR STAFF US6 GN•tl' <br /> PROGRAM ELFMENTS SEAIRCM <br /> '040 s 3d <br /> t 3 <br /> l � s <br /> ENVIRON MENTAL-HEALTH 011-ASION FIDS <br /> C2 ttO1J5[NGAI3ATEMENT ❑ SOUDWASTE FACILITY <br /> tiNDERGROUNO TANK(V*T)C;LE!ANUP SITE(LQPI FOOD FACILITY Q soot WASTE VEHICLE- <br /> CA OTHER CLEAKDP arM RIaN-LOP,) <br /> iGO DAIRY <br /> IRcMO ) pou = i . ❑ PKG T <br /> EtEATMEtT PLANT <br /> 7, UNDERGROUNATANiK(M0NrrGF� CCHICIAEN RARCH <br /> �7 I-L , DOUS WASTE GENERATOkMa {pT�L 0 PUMPER TRUCKIYARD1CtiEM TOILETS <br /> O TIERED PcfLy111 CED FACILITY Q P000SPA ND USE APPUCAIIohi <br /> 0 T A.Tr=130DY PEIRCIgG � pUj�LIC WATER SYSTEM u OTKER(PLEASE SPECiFy ABOVE) <br /> ❑ MEDICA1.WASTE FACILITY <br /> e s of files from the list above by checking <br /> Z. )_ist up to ten addresSEs in the space above. Select the typ ( } <br /> the appropriate tiox(es). At(c=ast one file type MUST be selected. Fax to(20914 -0"l38 or mail to the <br /> ggdreU,-- indicated above- y inbnent for review will be Gvnfirmed <br /> 2 EHD will notify the a�pil" if an E t n files exist, An appo <br /> appraY.itnately f.ra bossiness days but no tater than tan(70)days after reseipi Of application. The fifes <br /> will 6 held for i rnazlmum of five bitsineSS days for teview. Appointments should be scheduled <br /> accorciingiy. <br /> 3. A file that is actively being worked on by EHD staff May not be ip►t1RY'diatEcly available for review- Anew <br /> appiication may be s;.lbmitted where the file is available. <br /> 4. Any file 1104 returned,sn the same condition as released will tie reorq:anized by FHD staff at tho expense <br /> Of the applicant_ Future file reviews by file same applicant may require a$87.00 deposit prior to review. <br /> 5. *TENTAT IVe appointment dates must be wnrQtned with EHP Staff. <br /> b. Applications reesive8 after 3:00 prn will be processed the next business day_ <br /> CONFIRMED APPOINT•MEt-[T DATE TIME <br /> DATE E CONFIRMEDPHONE FAX INITIALS <br /> _ <br /> REViE'NED YES NO REVIEW DATE <br /> TOTAL P.01 <br /> F!1 GO 14 WO-7100 <br />