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SAN JOAQUIN couiv'rYPUBI_IC HEALTH SERVICES <br /> RUS <br /> 'WIRONMENTAL HEALTH DIVISIC! <br /> 304 EAST WEBER AVENUE,THIRD FLOOR' <br /> STOCKTON CA 95202 <br /> ` (209) 408-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT _U re. 0-6BUSINESSIAGENCY LfOUC1-q d <br /> c <br /> ADDRESS � <br /> PHONE ,Pd 49 FACSIMILE <br /> j J �f <br /> TENTATIVE'APPOINTMENT DATE f TIME I/+� Z 8-.) <br /> (P{ease give 7 to 10 b slness days frgm data of applivaCon submittal) co <br /> Go rr-3 <br /> �] -G-I <br /> GFtECI(BOX TO EXPEDITE REQLI T-376.00FE -REQUE T RQ ESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> z �] <br /> FIL A KESS <br /> ` T r f <br /> t7 A! W5 <br /> lel /,;t d <br /> �► 1� <br /> �J7 4 AA 17 �51 <br /> X31 <br /> =5 nV b rare 1<4 .V 26, 'S-D-7a 3�� <br /> ? t _ <br /> pro . Ind riks .. L%O tynt�{ ur' D8 - Romt�"' #i'$sA6.W-r.-, 3 r <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP SfTE(LOP) O HOUSING ABATEMENT ❑ SOLID WASTE[=AGILITY <br /> OTHER CLEANUP SITF(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> UNDERGROUND TANK(MONITOAINGIREMOVAL) 12 DOG KENNEL ❑ DAIRY <br /> HAZARDOUS WASTE GENERATOR 0 CHICi(EN RANCH ❑ PKG TREATMENT PLANT <br /> d TIERED PERMITTED FACILITY d MOTEL)HOTEL ❑ PUMPER TRUCKIYARPICFI1=M TOILETS <br /> O TATTOWBODY PEiRCINIG Q POOLISPA 17 LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY 0 PUBLIC WATER SYSTEM l740THER PL&ASE SPECIFY ASO <br /> �Vks 3 `Rc I-S C*a clad <br /> 1. List up to ten addresses In the space abave. Select the type(s) of files from the list 4bOVe by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-Dl 38 or mail to the <br /> address indicated above. <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 (40) clays after receipt of application. The files <br /> wilt be held for a maximum of five business days for review. Appolntments should 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 new <br /> application may be aubmltted 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 applicant. Future file reviews by the same applicant may require a $78.00 deposit prior to review. <br /> S. 'TENTATIVE appointment dates must be eoriflrmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE= TIME <br /> DATE CONFIRMED _ PHONE: FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> F" 09 14 01p3ma — <br />