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1_ 1 + 9 G39:� iPi <br /> dh7E RECEIYEO ri1:_'._.11 '�1; a•.d_ <br /> SA 0AQUIN CVTy 6UIC HEALALE <br /> F_YtD Lfxi NlM.R6Eiv _ ��_ <br /> ENVEFiONIV11~hITAI HEALTH DWISION1 "E" <br /> 304 FAST WESER AVFNUP,•tMRD FLOOR " �^Rg <br /> 'EI <br /> STOCKTON CA OS202 <br /> (209)463,U20 DEC 2 3 1999 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> �.^ iviC v i-! ALTH <br /> APPcicawT �l� i r7WIl jy4d Bt)SIHEssI,�d�ricY �fCaw <br /> ADDRE55p�,, �� 1}YiCEi�tT� Y ?yr�yr-- `+� --'�.l•f <br /> PHONE-1531/ FACSIMILE, 3! <br /> TIrNTATIVE"A PcwTmt=lx oAm JZJu&4 14,E TIME 1j2=00 0� <br /> (P1e;pSe give 7 to 10 btasirsess days tram dale of appiicallcn submittal <br /> CHECK BOX TO EXPEAITS REQUEST-376-04 FfE-RE01T.ST PROCESSEM IN 3 VAINM BAYS <br /> SIGNATURE OF APPLICANT C�L�t Ut3� DATE �� Z <br /> FILE ADDRESS <br /> Y <br /> .t. t <br /> > cls <br /> F <br /> +�1kV LIO-L <br /> D G <br /> r7 f S . C L,4-6Tr- <br /> S- <br /> -� <br /> ENVIRONMENTAL HEALTH DIVISION F=ILES � � ���Z`" <br /> ® UNWkGROUND TANK(UST)CLEANUP Sn-P-9-OP) C3 HOU31NG ABATEMENT C) SOLID WASTE.tcACILfNy <br /> B 0TI4ER CLEANUP SITE(MON-LOP) 0 FOOD FACILITY ❑ SOUD WAStE VEHICLE <br /> K UNDERGROUND TANK(M`ONrrOM"WRF-UQVAL) Q DOG KENNY. A DAIRY <br /> 9 TIERED <br /> IaCt3S WASTirrEb GENERATOR Q MOTELFNOTELrHtcxEN CH L3 PKG❑ PUMPER CKIYARDICHEM TOILETS <br /> ENT PL^NT <br /> C TIERED PERMITTED FACILITY <br /> 13 TATTOOMODY PEIRCING 0 POOL15PA O LAND USE APPI,I6AT"S17tES <br /> C3 MMCAL WASTF.FACILITY q PUBLIC VVATeR SYSTEM 0 OTHER tPLI:ASE SPECIFY ASGVE) <br /> '!. List up to ten address in the space above. Select the types)of files from the list above by checking <br /> the appropriate box(es). At least one file type MV$T be selected. F to 209_ 4F�4-013 or mail to the <br /> addu=indisab h9ve. <br /> 2. EMD will notify the applicant if any END files exist, An appointment for review will be confirXncd <br /> approximately fire business,days but no tater than ten(10)days aftecteceipt df appncation. The files <br /> will be he)d for a maximum of five business days for review. Appointments should be scheduled <br /> a r.cordingly. <br /> 3. A Mile that is actively being worked on by EHD staff may not be immediately available for review. A now <br /> application may be submitted when 010 file is available. <br /> 4.. Any file not returned in the same condition as released will be reorganl¢ed by END staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a 67&00 deposit priorto review- <br /> s. <br /> eviews. "MNTAnVE appajntmenrt dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> �x <br /> � , ,,,.,• '' � t 1TI S �.-.i.�x' r tits��.. <br /> N 1T aR• <br /> Y. 1t� •tet. u sr� <br /> �P�3�. f +,,f7 ,Ay ='N � i. -•r �t i:�'£"'y✓'^-i '4.� +Ya Y s'�'I•u l'; �r"7j i 1�c va <br /> .`.ey <br /> B/.i9v99 <br /> ToTHL P.ix? <br />