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,SAN J"UI - <br /> �rw'n��Y� _ �}ta�oG Nuriaert <br /> N CQUNTYPUBLIC HEALTH <br /> ENVIRONMENTAL HEALTH DIVISION 1; <br /> 304 EAST WESI=RAVENUE,THIRD FLOOR `• ;`;. `. '' <br /> STOCKTON CA 95202 <br /> (209)458.3420 #�+VI1?�iV"� <br /> PUBLIC R2ECORDS RELEASE APPLICATtOli ,-r EN?_ <br /> APPI iCAtyT M � allSINES51AGENCY G7Cl C t•�••7 <br /> ADS9 V , <br /> PHONE <br /> FACSIbt]LE /1 <br /> TENTA`TI'VE"°APPOINTIAENT''CiATETIME <br /> (pl*asd give 7 to to business days from date of applicauen submittal) <br /> CHECK BOX TO EXPI`DITE REQUEST-$87.00 FFE-REQUEST PROCESSED IN 3 BUSINESS GAYS <br /> SIGNATURE OF APPLICANT 0?�l DATE �� <br /> FILE ADDRESS 'TH SIDE EHD STAFF USE ONLY <br /> PROGRAHf ELEMENTS SEARCH <br /> 4 "• - 30� E <br /> AA <br /> IM E, YdWUI— <br /> � 'n '�•s•2(v rN:v <br /> D3S.a9 aZ4.G0it h <br /> 1 W. ffim!2 <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> i i UKQERGROUND TANK.(UST)'CLFAFIUp SITE(LOP) 0 HOUSING ABATEIIEIENTSOLID WASTE>"ACILIV <br /> ❑ FOOD(FACILITY M SOi.IO WASTE YEHII <br /> OTHER GtFAH11P SITE;(FirJN-COPi �; . <br /> UNDERGROUND TANK(MONITORINGltUICIVAL) 0 DOG KENNEL LI DAIRY <br /> J�IrHAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PF_RMnI FACILITY E3 f,10TEL1110T1:i. E3 PUMPER TRUCKIYAROICHEMTOILII <br /> fl TATT00ARODY PEIRCING 0 POOLAPA AlLAND USE APPLICATION SfTI`S <br /> ❑ 14501CAL WASTE FACILITYUQkWATWSiYSTE�I d pTHER(PLEASE,SPECIFY ASOl <br /> 1. List up to ten addresses in the space above. Select the type(s)of flies from the list abhve by checking <br /> the appropriate box(as). At least one fila type MUST be selected. l=ax to(209)464-0138 or mail to.thg <br /> address lndlcated 81b.Que. <br /> 2. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10) days after receipt of application. The files <br /> will be held for a maximum of five business clays for review. Appairttments should be scheduled <br /> accordingly. <br /> 3. A file that IS aetively-being'worked on by EHD staff may not be immediately available for <br /> review. Anew <br /> E alpplication may be submitted when the file is available. <br /> 4. Any file not returned in the Same condition as released will be reorganized by EHD staff at the expense <br /> of the a pplicartt. Future file ivlews by the same applicant may require a$81.00 deposit prior to review. <br /> 5- 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after I=pm will las processed the next business day. <br /> CONFIRMED APPOINTMENT I3ATlr TIME <br /> DATE CONFIRMED PHONE FAX 1N171ALS <br /> RFVEFtNFn YF9 MCI PWIII nAYr <br />