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.__!-___n01/07/2004 WED 14;30 `FAQJ00210�Q� ! <br /> uirvricuu4 1G:K+4 Y iso r_NVir%LNMt4Ilrklt�In <br /> COUNTY DATE REE11/i=t� � <br /> SSANJdAQ <br /> K tutu Llnxnumu�i�' <br /> R [%I_J I ..y;I i /i EN r ZRONiTll N Jl AL HEALTH uCi DEMME 1. <br /> 304 E Weber Ave 374 Phar Stockton,CA 95205 <br /> JAN Q 7 2004 (209)46s-3420 Fgx.(209)464-013$Web:wwwxo.san jvaquin.ca.usfcbd <br /> PUBLIC RECORDS RFLEASE APPLICAnON <br /> RERMl <br /> APFLICAIVT: �11 C -- tit1S1NFS3UGEl[GY: <br /> PHONE: / -002Z 1 a I I FACS111RIi E: <br /> TENTATIVE'AFVOIN WFXT DATE:_�/I0 Time: <br /> �W <br /> (PIaa3F allow is buslerass da}�a t daft of apptleatton sub Tftal} <br /> p 5r0CKTvN <br /> CHECK BOX TO EXPEI)rm REQUEST-"3.00 FEE-REQUEST PROCES3ED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICAN3 BATE 1 1 <br /> Depal4rant Llr^Only <br /> FILE 1u MD MS UNrr <br /> soda l�5 �h f! S7¢G D �] unit I <br /> O! 5 l/ PA <br /> F <br /> s itIh1� Unit 2 <br /> a. oa elf <br /> s, sand 5dD I! NAV 1 n [3 Unit 3 <br /> mot / r r-l-/E 4 WIS a 9 LUnit 4 1 <br /> >s sI�I S D x�.ToN Ili - <br /> nit 5 <br /> �. serer <br /> 10, seed <br /> ENVIROWtNTAL;HMTH DEPARTMENT FILES i <br /> CLEANUP 5fTE p-OP) Q.HOUSING ABATEMENT M fbLM WASTE FAG <br /> ��y�m�ERGROUND TANK{MT) p FOOD FACILITY Q SOIJO WASTE VEHICLE <br /> LF1'p I R G1,EANUP SITE(NONA OP) D DAIRY <br /> 1:3 UNDERGROUND TANK iMONITMINGIMMOVAL) 4 DOG KEMEL 0 PKG TRSKMEXT PLANT <br /> is HATARDOUS WASTE GENERATOR C CHICKEN RANC14 <br /> 0 mOTELMOT£L fl PUMPER TRUCKWAMMR12M TOILE <br /> a TIrRED PRMMTM FACILITY 0 LANUSEAPPLICAMNsnTIS <br /> 3 Tpt <br /> E3 MEDICAL WASTE FACRJ Y Q O if1FR(PLEASE Sp6CI <br /> FY} <br /> 1. List up to ten addresses in the space above. Select the type(s)Of files from the list above by checking <br /> the appropriate box(es). At least one file typc MUST be saleated. Fax to f20M 4"-04"-0138 o i1 to the <br /> address lndteate_d_a, Ove. I <br /> 2, EHD will notify the applice,nt if any END tiles i4st. An appoint"fat for reVlevsr will be confirmed files f <br /> approXlmately five buSineSa days but no later than ten(10)days after receipt of aPp <br /> will be hetr>�'far a Maxllnuttl of five business days for ni:vlew. Appointments shadld be scheduled <br /> zccordlngty. <br /> 3. A file that is acfively being worked on by E11413 staff may not b8 immediately available-for review. Ane <br /> applicatiorirmay be submitted when the 411e is Available. <br /> ,4. Any fife not r+?tUrrted in the same condition as released will be reorganl�ed by E"D staff at the expens <br /> of the applicant. Future file reviews by the same applicant may regUlre a$93.00 deposit prior to reviles. *TENTATIVE appointment dates must be carlfirrrled with EHD staff. <br /> 6. Applications received after 3:00 pm will be p"Kessed the nett baslness day. <br /> GpNF1RMoINTMENT'DATE TIME <br /> ED qP <br /> bATE GgNF1RIVf 'PHONE . FAx.- JNfi'IALS <br /> 'REVIEWED , YES NO REVIEW DATE' <br /> rrercaos � <br /> r <br /> .. i <br />