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— r-',ik OAQUINCOUNTYPUBLSCHEAL7IIS ACES <br /> EWRONMENTAL HEALTH DIVISION <br /> APR 0 7 2003 3"EAST WESER AVF-NUI:,THIRD FLOOR --R30 <br /> STOCKTON CA 95202 I <br /> CNVIRMPA' <br /> (209)46&3420 <br /> RMITCNiI DS <br /> RELEASE APPLICATION <br /> �APPLICANT �r aysiNE55/A(3fiNCY LIDS 4/,*I <br /> ADDIRESS—SX(Ld�- S • 11-k ate-, D a l IA!�/ Li¢ <br /> ?HONE S I17 �/� S l tl FACSIMILE w)<t 7y- 3 �6 q XA% Joh �n¢o-r <br /> TENTATIVE'APFOINTMENTDATE 45 Spn,) AS OOSSi6�e TWE 1&N4 � dinl�'Rd Qr�l�LAS/SSS <br /> (>It&"ylva T to 10 huslnali d">ram Cnt!of:bppUcrtion subml 1)jl ar" <br /> u CHUCK 9oX 76 EXPHDrrI-REQUEST-=89.60 F'EE-REQUEST PROCESSED IN 3"LNPSJ DAYS <br /> " S1GN/1TURE 01=APPLICANT �� __ DATE <br /> -- "" is SID <br /> FLZ An ORE" PROGRAM ELEMENTS SEARCH <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> 7 HOUSING ABATEMENT O 8000 WAS M FACILITY <br /> A <br /> UNDERGROUND TANK N3T1 CLEANUP SITE(LOP) 0 FOOD FACILr Y ❑ sOUD WASTE VEHICLE <br /> OTHER CLEANUP srrE MON-t-CP) ❑ Don KENNEL U DAIRY UNDERGROUND TANK(MGNITCRINGIREMOVAL) 6 �ICKFN FANCH o PKG TREATMENT PLANT <br /> � HAZAADOU9 WASTE CegwiATDR ❑ /�OTpllN4TEL d PUUPER TRUCK/YARD/CHEM TOILETS <br /> O TIEICED PERMTrTeD FACILrUe m PQrnMCUSPA O LAND USE APPLICATION SITTS <br /> ❑ TATTOO15ODY PWIRCISO CJ � O OTHER(PLEA6b SPECIFY AJ3OVE) <br /> 0 MEDICAL WAST:IrACIL1TY <br /> �. hist up to ten addrE.tsa+;In the space above. select the types)of files from the tilt 209)464-Q;3ov rbmail to theg <br /> the apl>Iopriate sor(e>c). At Ieast one file type MUST be selected. F <br /> adid rrlaa'I ice° 513 0Y, ny appointmont <br /> 2. �Dc xIi'n;ktely itlre businsas days but Dnoilater than tles exist- un(10)days xitar0receipt of appUcati nI.The files <br /> pp ointments should be Ijcheduled <br /> w111 be�,.ld for a�rr�:lximum of flue business days for review. App <br /> accordingly <br /> 3, A Elle t;tat is aCtl rely bel <br /> worked on by EHD staff may not be immediately available for review. Anew <br /> applic:Rion may by submitted when the fUe i$available, anized b EHD stat(at the expense <br /> d. any fila not rotumcd in the same condition as rolexs <br /> of this applicant:. Future file rnviows by the same eppli will t>e recAnt may require a$89.00 deposit prior to review. <br /> Y <br /> 5 'TENT.INTIVE appointment dates must be confirmed with EHD staff. <br /> 6. APpll"eons received sfter 3:00 pm will be processed the next business day. <br /> TIME <br /> CONFIRMED ApPOINTMI:ENT_DATE <br /> DATE CONFiR)ul'E:D <br /> PHONE FAX INITIALS <br /> YES i <br /> �VIEINED NO pyv1EW DATE�- — <br /> S:d WUS0:01: :=00Z 2_0 -ld'd ON XdJ WOdj <br />