Laserfiche WebLink
� 1>nr -- A rrrt-x tiiV1KOTELH.INC. S88 <br /> P <br /> rvao NO 2"` } <br /> �' =' --1=✓ S 'lAQUIN CgUNTYPLIDi,[C <br /> HEARVICES <br /> ' :: ENVIRONMENTAL HEALTH DIV ION <br /> APR 2 3 2004 304 EAST WESER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> (209)468-3420791 <br /> P PUBLIC RECORDS RELEASE APPLICATION � <br /> APPLICA?1T � ulRi'(� �D ( c <br /> 8,1131�jhfESS1ACyEAtCY—Aft G-r l.� fi{� i <br /> ADDRESS It y P Ir(fez W GOO, ' I oar C.A 956-74 <br /> PHONE 31fo ✓ - (~j WSWILE cu — S-S t-C I 1 <br /> TENTATIVt'.APPOINTMENT DATIr TWIQ s _ <br /> (Please Chn 7 to IQ business days from data or applleation rubetilWAI) <br /> CHECK BOX TO EXPEDITE REQU 0a FEE--R>QU"T PROCMED IN 3 DUSDIM DAYS <br /> SIGNATURE OF APPLICANT DATE / <br /> 1-1-61 <br /> O <br /> FII„E ADI3RESS TRIS SIDE€HO STAFF USE ONLY <br /> PROGRAM>ELEMENTs SEARCH <br /> 4SE1( 5( 2 <br /> D oel Ile- <br /> qr>Q—E. <br /> � I <br /> 00 4- <br /> �I✓ 511 r <br /> ✓ l 5E r. <br /> 4(` <br /> 5 - <br /> ENVIRON ENTAL. HEALTH DMSION PILES <br /> uNDERGROUND TANK JUST)c1,I=MVP SITE{I,OPI Cl HOUSING A$ATEMENY 13 SOLID WASTE EACIi rZY <br /> G OTHER CLEANUP SITE(NON-LOP) 1� 10 FOOD FACUM C1 SOLID WASTE VEHICLE <br /> 0 UNoERCROUNO TANK(MONITORINGIREMOVAl.1 C UOG KENNEL 0 DAIRY <br /> a PAG TRgArMENT PLANT <br /> M--HAZARDOUS WAS�TC-GENERATOR A CHICKEN RANCH <br /> 0 TIEREa PERMTrMD FACILITY ID MOTEUMOTFL, 0 PUMPER TRUCWYARINCHEM TOI}El <br /> 11 TAITOOIOODY PEIRCING V POOLiSPA r3 LAND USE APPLICAYION-SITES <br /> 0 MEDICAL WASTE FACILITY 13 p'uauC WATER sYSTEiMt t3 OTHER(PLEASE SPgCIFY ABOV ) <br /> 4. List up to ten addresser.,in the spam above. Select the type(s) of files from the 11st above by check I <br /> the appropriate box(es), At least one lila type MUST be selected. Fax to 209 X464,0139 or mall to t1 <br /> address Indiclated ab'ave. I: <br /> 2, EHD will notify thea applicant If any EHD files exist. An appointment for review will be confirmed <br /> approxlmataly five bukin Liss days but no later than ten(10) days after receipt of application. The fill ? j <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that,Is actively W" worked on by EHD staff may not bG lmmedYately avallable for review_,A w <br /> application may be submitted when the fila is available. <br /> 4. Any file not returned in the Same condition as released will be reorganized by EHD staff at the exPf : 6 { <br /> Of the applicant. Futurepie reviews by the same applicant may require a $89.00 deposit prior to reW. <br /> 5. *'TENTATIVE appointment dates must be confirmed with EHD staff. �q <br /> 8. Applications receives!after 3:00 pm will be processed the next busines at ^:I 1 <br /> CONFIRMED APPOINTMENT DATE, TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> RI"VIEwEG YES :No REVIEW PATE <br /> E <br /> ly <br />