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08-14 -09=23RId Thi [ �7145434723 P-01 <br /> t <br /> SAN JOAQUIN COUNTYPU13LIC HEALTH SERVICES <br /> AU� �. �t�lil ENVIRONMENTAL HEALTH OLVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR U l <br /> STOCK'TON CA 95202 <br /> Ei•4VRON',\tiEr�' . ; ;! (209)468-3420 <br /> PEPWI I/SEF'`v" PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICAKrti�_UKE NAotjx CaUt; DtlSiMtC5S1AGENCY� b _,� !Tile _�e.1�. _ �� <br /> ADDRESS,IkORO E. L�th STREE-r' 2A0 S,11kt�QTf,--LOA D1 <br /> Ptt4Nf- 3, � <br /> rACSIMIiE._ <br /> TIVG*APPOINTMGN7 DATE I�-t0�0�) TLm^r- <br /> or� � � L� <br /> (Picase:Jivit 7 to IQ bwincsr.days(coon data olspp-1€eali4n Svtlmiltol) <br /> fit) <br /> CHLCK DO%TO."PE;ITIE REQUEST'-$,81.OU FCC-•RVOUEST PROCESSED}N 3 OUSINE33 0AY5 <br /> SIGNATURE OF APPLICANT � 4 <br /> DATE AUC,. P1 z 5 <br /> IAO <br /> FILE ADDRESS THIS 510E bmD'%mm U5E ONLY <br /> PROGRAM t:Lt:kEN f 5 SEAHCI! <br /> 'm-s-- <br /> t <br /> O <br /> 2! 20 G <br /> i ro 2Q <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> U114 r'ROUNU TANK tUST)CLEANUP;SITE(LOP) ❑ HOUSING AIDAYCNEMT SOUD WASTE FACILIYY <br /> OTM4R CLLANUP SITE JMON-LOP) ❑ FOOD F'ACII.ITY ❑ SGUO WASTE VEI IICLC <br /> UNDERGROUND TANK(MONITORINGIUMOYAL) ❑ OOG KENNEL Cl UAAY <br /> HAZAROGUS WA5TE GENERATOR 0 CHICKPM RANCH Ct PKG TREATMeNT PLANT <br /> a T1CRO PER0917 ED FAjt;U TY ❑ MOT"WHOTEL D PUMPEit TFiUCK(YARUICHEM 109LEls <br /> L7 <br /> TATTAOMODY P6RCUAG e3 POOUSPA ..� ❑ )LAND USE APPUCATION SITES <br /> n MEo�ALYVASTrFACILITY O YUsLiCWATER SYSTEWI 0 0'uienirLrmr_sPEcir-YAU0VE) <br /> 1. c -List up to ten addresses tri the spats abovo. Select WO type(s)of tiles from the list above by clucking <br /> E .the appropriate box(es). At ICast one file type MUST be sclocted. FaX to(2091 464-01_�b or mail to the <br /> # address-indira3gdjtiovc. <br /> 2. EHIa will notify the applicant if Any EMD files exist. An appointment for review will be confifrttad <br /> approximately five businoss days but no laterlhan ten('1o)days after receipt of application, tato files <br /> will be field for a maAiMUM Of five business days for review. Appointments should be scheduleff <br /> r accorclingly. <br /> 3. A flit;that is actively using worked on by ENO statt may not be ienmediatciy Ovailabla tar fCYWW. A now <br /> Application may be submiitcc(wrhon.the file is available. <br /> 4. 1 Any fife not returned in ti-to sarna aonditiou as rcicascd will be rcargdntzed by EIJD staff at the oxpcn.^.0 <br /> i of the applicant. Future file reviews by the Sane applicant may require a$87.00 ditpoadt prior to review. <br /> 5. I •TENTATIVE sppain tlnent;datis must be confirlMad with EHD staff. <br /> 155. Appticatlons recelvod after 3:00 pat wili-be procossed the next-business day. <br /> i <br /> r <br /> l <br /> CONFIRMED APPOINTMENT DATE TIME <br /> f3Aff=04NFIRnnFa _ PHONE FAX INITIALS <br /> d rzVIF_WED YES NO REV1Ew nATr- - <br /> TOTAL P.01 <br />