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TE s <br /> C - RENO ax 5-5 3- t 1a�; 4 �uUZ L4 s <br /> ENVIRONMENTAL HEA. <br /> f PAGE 41 <br /> 81I$4/2062 14:35 _ 4646188 4 <br /> onYs�.cr�+sv SAN J{)AQUIN COUNT1PUBLiC HEALTH SERVICES <br /> A/ <br /> ENVIRONMENTAL HEALTH DIVISION, <br /> R u� 304 EAST WEBER AVENUE,Tt4lRI)FLOOR' <br /> STOCKTON CA 95202 <br /> (209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION , <br /> cls � USINESSI IINCY I <br /> X APPLICANT, , �}��.., Q AP-�i� <br /> ADDRESS PHONE 2x0O FACSIMILE <br /> jjpttcTIME t � <br /> TETATNP APPOINTMENT PATE :.,cc ploc <br /> {P1eas*give 7 to 10 Ausin <br /> z <br /> tutsml4tat); <br /> LII7� <br /> ca�Ct BOX To apabITE REQUEST.SS9.00 Ff;R-#�EQUI V RSICI;%ED IM 3 BUSINESS DAYS y <br /> :SIGNATURE OF APPLICANT <br /> �'t I7AT� l a <br /> THIS s�oE II�a 87AFF use gpll„Y � <br /> FILE ADDrtTcS8 ,+ PROGRAM 151.remem SFJ►RG:N j <br /> I <br /> ,•,R Ch .20 Lf <br /> - <br /> i <br /> NvlltciN 4VN'rAL HF.ALTH 131VISION FILES <br /> D SOL11)WASTE FAGILrrf <br /> UNOV90ROUNOTANK(USY)CI.EMP$01i tL� C: HOUSING ABATEMENT ❑ SDOD WASTE VORCLE <br /> C FOOD : <br /> OTHER CMANUF SITE("00100 C3 boa M:�NNEt CI DAIRY <br /> UNDERGROUND TANK tINO RIN..M. ..,OVAL) � GNI+CIGEM Iil4NGcai d FIKC YRFATMr;NT#'t.l� Y <br /> wx►FtDfl1S[tttA'FrfEOEM.9RA"TOI( L pumpt-P,T9UCKiYAAb1C)49MT4 , <br /> d TIERED rk uI la KACIa�Y C], AKOTEL1HGk L7 tANt7 USE 41a>iiJCAYION VMS <br /> M TATTOOMODYPEMCING Irl POOLISPA <br /> A I4TEC�1CAt.WAt#R•Fl fk.iTt+ 0 PUOI.ICWA't�"�!$Y$itl:dll CI �1TiiER(PLEASE SP1 CiFTABOYEj <br /> Last up to ten aatal;~essee In.1116 Space above. . <br /> 50jeCt the type(g)Of file$tram the list above by checking. <br /> tIto appra�prlatc t oxtest At Least dinif lila typo MUST be 9*1*fed Fax#c t2 9464-0138 or mai[to ll e <br /> EtiD vtit"ndic�iad abQv <br /> i notify the applicant it atter EHO file$exist. An appaiTl ert for review willbe coion. Td <br /> ica <br /> 41pptoximateiy Roe businisss dayal but no tatter than ten(30)bays o trn�tsp�Of tioutd be sche�tuleilhe fites <br /> v�riil be held fora to tmurn of fiva laustness days for ravlow. App _ <br /> accordingly. <br /> 3 Afile that t5 400.aytyballo w asked ch by END staff may not be imfnediately;stvailabfeiar review. Anew <br /> appitcation ntati:ba'sutimatted vrhon the tile is available. <br /> A> l tic r,ot returned in the same condition as released Will be rearg2n&*d by EI4M:6taff at the a <br /> xpaass+e <br /> of tlis applicant. Future Lilo reviewsby the ssarm+t applicant maty req�iire a�fl;tt+po deposit prior t+�r>tt►i YtCr; <br /> 5 NT111YYE appointmolft atmos must be conflrM*d with EHD staff. <br /> 6 ATaplitalllras:roa sevi:d a►fler.3 0 Pmo< tiff ba prrotessed the,next pvsin 2 day, <br /> I <br /> +CiW7►T FXRi 4iF^I a PPOINTViENT'l AT <br /> TIME <br /> 6*MCONFii~tM50 <br /> PHONE FAX INITIALS �.� �..... <br /> RtVIE N DATE <br /> NOt <br />