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.�••.�..,......',h•. I.I rLr 4 V 4 I+UIJy-r17: <br /> ' SAN .J QUIN GOU14TYPU5' L1C HEALTH S RViCES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> -304 EAST WEBER AVEKIJE,TI-'IIRO FLOOR <br /> STOCKTON CA 85202 <br /> (205) 4&a-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPf_fCAh"fGo win5 Sf}SSMEISSJAGIIUCY 7 [._ '( �'�J <br /> �aFtFSS 170 <br /> i'HC7lV� <br /> el-71)c FACSkAiIL L' <br /> TENTP.'1 1S/E AFPOari7rA>NTAATE 1 y + Tima <br /> (P'.ca4a Qivc 7 to yR bupincss days from date of appliC-JIon s1lAre J al) C <br /> CH:Cx SOK TO 571PEA rre flzQUF_3T ,DD RM-REQ ST PROCEaSI�jN 3 8t15INE5S DAY'S <br /> -51GNkTuFtE orr APPLICANT I DATE:�� <br /> r k <br /> FILEC ADDRESS THIS SIDE E90 iTAFF USE ONLY <br /> I <br /> PRPU RAM LLEMENT5 SCARCti <br /> C <br /> ' I <br /> �-T L� <br /> • i ' <br /> i <br /> ' <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> 1JNPJ;RGROUPiP TANK(UST) GLEANU�STT:(LOP) ❑ a-IOUSIAtG AaATFMENT SOLID WASTE FACILITY <br /> OTHER Cf l fUF517 {NCNf•LOP} �: 0 FCIO�?�AGILIZ^{: _� 5OUDWASTEVEKICLE - ------ <br /> UNDEKGROuxu-rAHx IrKGHiTc�i[�tGi i"ilpvAy >Mt DOG KEl�HEL C3 DAIfS7 - <br /> KA2ARI]OU5 iWAS�GF-HERATOR Q CHJCXESN RANCH O PiCGT[i�AT�NTPL11l+tT <br /> TIERED PER2r =F_D FACILITY '• ❑ MOTELiHQTEL 17• PUMPER TRIJCKlYAfiDJCHfrlrf TOILETS <br /> ❑' TA TOU130DY FE[RC[HG } Q p001fSPA ❑ LAND 1USEAPFUCATiON SITES y <br /> Q MEDICALwA_�TIr FACILITY 0PU8L1C WATER$YS7PN C3bTa4Uft[PLEAS!'SPEClFYA80VE] i <br /> 'f. List tap %o, mn acJaressas;in me spaco above. Selsct the type(s) offilaa; fram the list abov8 by Wwcl in <br /> fife appropriate bvx(es)_'•At least one We types lYIUbT do slalacted. Fax ta•( Us3 464-9�3$_ar mai[to hr q <br /> dresa indJcated ab v. • <br /> Z-' EHO Will notify the applicant if any UZ files exist. An appolntmezzl#dr rev!ow will be confirmed <br /> approximately frve business dayr.but no later than t6n f10)days after receipt of$ppllcatian.,Trio flies <br /> will be held for a rn=imurra of five businoss days for revlaw. AppoirIU-nont-S should be sche fulari <br /> - . aacnrdils�Jy. <br /> I, 3. A rile that is uctivcly befrtg workad on by E>•!D staff may not be immadlatoly available tar review. A new <br /> appJication may be SUbrriltted When the file is.zvailafale, <br /> Any Elle;not returned Jn tic same condition as released will be reorganiaad by END staff at trio expense <br /> of the applicant. Future file reviews by the same appllaaAt may requir•a a$87.00 deposit prior to ren►lew. <br /> 5. -rENTATiWE appointmedt dates=41 be cunfirmed with EMQ staff. <br /> 6. ASIplicaX.ons received afar 3:00 pro will be irrocassed tha next business day. <br /> t <br /> r <br /> �CAFIRMEI) APPOINTMENT DATE 7111AE <br /> DATE-CONFIRMED _ PHONE FAX JN171ALS <br /> (21*11lBVVED YES NO REVIEW DA'T'E <br /> �ho4t mb . <br /> 7C1TFL F'.Id1 <br />