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SAN JOAQUIN COUNTYPIJFiWC HI=ALTH SI=RVICES <br /> ENVIRONMENTAL- HEALTH DIVISION , <br /> y APR 304 EAST WEDF-RAVENUE,THIRD FI-COR <br /> STOCKTON CA 85202 <br /> 46$ 420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APFER'xNT 5U5iWi51AGzLNCY— <br /> AAA:�sS D� <br /> PItOPiE r�� FACSX&E I <br /> TENTATIVE."APPOINTMIENT DATL - TMAE <br /> (Please Siva 7 co 10 oystness clays from 0412 of applic3tiori�vDmi Il <br /> CNEGK:30X TO ExPrri�ITE RECitI r-:�7 Ff� - EZTnPROCF-SSEA If13 BUSU*,ESS PAYS <br /> SIGNATURE OF APPLICANT �' !! �`�� DATE <br /> FILE All THIS SIDE EHO STAFF USE ONLY <br /> PROGRAM ELE]WI=HTS SEARCH <br /> ENVIRONMENTAL. HI=ALTH DIVISION FILES <br /> UfJRb RGRt}UttA TA►IiC(UST)C61FANUP SIT£(l OM R iiQ"ING At3AT MIF-l'a iQ=INASTE FACIE(TY <br /> ri6R G�&A>VIJP SITI=�c t3 t�P} FOOD FAcli_CfY SOl1D WASTE VEtliCl E <br /> NpE.Rr3RQ�tPlO TNI <br /> ANK(MOTOMNGIRE140VALI C3 DOG KENNFI- Q DAIRY <br /> CIiA24+RAOUS WASTE�aEWc RATOR M CHICKEN RANCM PKG TREATMENT Pt-"-r <br /> C TiERV-D PE+J MEQ FACILITY Q MOTF;W"oTF-L o PUAWFR TRUCKfYA 1WCH"TQIL.E.T5 <br /> Q TATI Q01R0]Y MFtCWiG M POOWSPA - C3 LAUD USE APPt.lCAYIOdd SITES <br /> C MEDICAL WASTb FACILITY ❑ PQtjLIG WATER SY4-TL d M OTHER IF'EASE 5FI-CIFYAt3OVel <br /> I. List IIP to ten asldr055as in the space aboYa. Select the types)of files from the list above by checking <br /> the appropriate box(e5)_ At least one file type MUST be selected. Fax to (20)M-44138 ar Mail>0 The <br /> addiTss <br /> 2_ EhD will notify the appil"nt if any CHO files exist. An appointment Tar review will pia confirmed <br /> approrimateiy five business pays taut no IWar than tete(10) days after receipt of application. The filas <br /> will bo held for a maximum of tNe business days for review. Appointments shouid be scheduled <br /> accordinaly_ <br /> 3. A file that is actively being warKed on by FHD staff may not be immediately available tar review. A new <br /> application may be submlaaa when the fila is available. <br /> 4. Any file not rerimad in the same condition as released will be reorWized py l=HD staff at the expense <br /> of the applicant- Futury file reviews by the same applicant may require a,$87.00 deposit prior to review. <br /> S. "TENTATIVE appointment dates must be confirmed with EHD�wff. <br /> G. Applications received after$:00 pM will be processed tits React business day. <br /> CONFIRMED APPOINTMENT DArE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> nmzlm4r�r% tiacz bin RPVIFW nATF <br />