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e3/05'2962 11:3e 4541 ENVIRONMENTALS ILTH PAGE 02 <br /> SAN JOAQUIN COUNTYPUSLIC HEALTH SEFivIGES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> (209)458-3420 <br /> PUBLIC RECORDS 'RELEASE APPLICATION <br /> APPLICANT <br /> GUS[NESSIAGENC• <br /> ADDRESS._ <br /> PRONE <br /> -\ ' Cv1C�2 FACSIMILE <br /> Y1/y� r.1 r1 'b <br /> TENTATIVE*APPOINTMENT DATE � � � � � TIME= <br /> (Please give 7t93-10 ouusiness days from d no pficatio submittal) <br /> �-•� �" � <br /> DESS DAYS <br /> C <br /> L� <br /> CHECK BOX TO EXPEDITE REQtIF-S - 89.00 FEE- S7 P O E sSED <br /> DATE �] " <br /> SIGNATtaRE OF APPLICANT <br /> THt5 SIDE EHD STAFF USF-RCH <br /> 55 ELEMENTS E <br /> FIi.1= <br /> ADDRESS PROGRAFA <br /> �'�S3 � • <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> HOUSING A>aAT>II+IENT O SOLID WASTE FACILITY <br /> CI <br />'F CK UNDERGROUND TANK(UST)CLEANUP SITE(LOP) MFOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> BOTHER CLEANUP SITE(NOWLOP) to DOG KENNEL p DAIRY <br /> KUNDVRGROQND TANK(moNrrORINGIREMQVAL) 0 DOG KI_N F-L O PKG TRI�ATMEN7 PLANT <br /> gzAIZDOUs WAST;_GENERATOR p CHICKEN <br /> RANTEL ' 0 PUMPER TRUCKNARDICHEM TORPTS <br /> ❑ TIERED PERMITTED FACILITY O pOTFLIHA C7 LAND usE APPLICATION SITES <br /> 0 TATTOO/SOD PGIRCING tZ"jjI3LIC WATER SYSTEM Q OTFIEIt(PLEASE SPECIFY ABOVE; <br /> O MpoiCA1_WASTE FACILITY list above b Ct1e:)Cin9 <br /> of files from the I y <br /> �• List up to ten addressor in the spate above• (VIIJSTtbe sepeated. 1=ax to 209 484-0138 or mai!tc_the <br /> the appropriate boxes). at least one f1e typ <br /> above. Will be confirmed <br /> a to d wi <br /> address iridic � � t for review <br /> 2, EHD will notify the applicant if any EHD files exist. An appaintm n or t of application. The files <br /> aplSroximately five business days but no later than ten (10) days aft <br /> ointmen4s Should ae scheduled <br /> will be held for a maximum of five business days for review. Appointments <br /> accordingly. F{p staff may not box immediately availalale for review. �k re1n+ <br /> 3. A filo that is'actively being.worked on by F y <br /> application may be submitted when the file is available. <br /> vire a$a3.cD deposit prior to raview- <br /> 4, Any fife not returned in the satme condition as released will be roorganized <br /> by EHD staff at the Q71IIen} <br /> of the applicant. 1=utura file reviews by the same applicant may req <br /> 5 -TENTATIVE appointrrsent dates must be confirrtted'with EHD staff. <br /> 00 prrl will ba proc9ssed the next buainOss day. <br /> s. Applications received after 3. <br /> CONFIRMED APPOINTMENT DATE <br /> TIME <br /> PHONE FAX INITIALS <br /> DATF.CONFIRMED - <br /> RENIEINED YES NO REVIEW DATE --- <br /> �AJIIJYR • - <br /> ,.,��, n� SSR t`Iv±�R �n�T.S zs�s ars RAZ 3'53 8"C�CT 'Tf1J, Z0�50�5'�' <br />