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111LJla_J'.�I:J . <br /> 11-14-2Uv�'id 1d3:ls1'rI rh I tlJ! ✓ '!U i mil vAOL,, -� u,u�w nuMau< <br /> Galt X61:CIVt� <br /> SAN JOAQUIN CQUNTYPLIBLiC HEALTH RVICES <br /> ENVIRONMENTAL HEALTH DIVISION 2+1 <br /> 304 FAST WEBER AVENUE,THIRD FLOOR <br /> STOCKLON CA 95202 <br /> (209)468•3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPUCANrr f C D J r BUSIN&=AGENCY W�t I k c z `"`�' A J J -0c,- <br /> ADDRESS 3 to St T 7 � f/K Q *ua vc C� <br /> PHONE .,_FACSIMILE 7D4-- 9 0 6 E <br /> TENTATIVE'APPGINTMrNT DATE TIME <br /> 1plea glv*T to t0 pusin¢sa day6�data of appki thin submittal) <br /> / <br /> CHECK BQXTO EXREDITE REQUEST-$87.00 FEE–REQU .. TPROCESSEDJN3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> FJLE ADDRESS THIS SIDE END STAFF USE ONLY <br /> PR90RAM ELEMENTS SEARCH <br /> 0 n7Ya C V <br /> D� Ut — <br /> O <br /> OLnADS — -- <br /> o W a an, S _ S <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> DBROROUNDTJtiYK(UST)CLEANUP SITE[LOP) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> !TNA <br /> TRGUPSITE[ ON-LDP} ❑ FOOA FACiI[TY O SOLID WASTE VEHICLE <br /> NDERGROUNDTANKhLaITORING7REMOVA7-) AO(+tCENN6L RA(ftY <br /> A7ARDQUSYfASTEGENERATOR CHICKEN RANCH 17 PKG TR6ATrdEN7 PLANT <br /> EREOPERMIT ST2GE LETYQ MOTEL(HOT2L ❑ P LIMPER TRUCKfYARDlCHEM TOILETS <br /> TTOOIBQDY PE)RCING ❑ POOUSPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDiCAL WASTE FACILITY Q PUBLIC WATER SYSTEM 13 OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addrksses In the space above. Select the type(s) of files from the list above by checking <br /> the appropriate boic(esj. At least one file type MUST be selected. FOX to (209)464-R'(98 or mail to the <br /> addre« indicated above. <br /> 2. EHD will notify the applicant If any EHD flies exist. An appointment for review will be confirmed <br /> approXimately five business days but no later than ten(10)days after receipt of application.-The tiles <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accorilingly. <br /> 3. A file that is actively being worked on by EHD staff may not be Immediately available for review. Anew <br /> application may be submitted when the file is available. <br /> 4. Any file not returned In the same condition as released will be reorganized by EMD staff at the expense <br /> of the applicant, Future file reviews by the same applicant may require a$B7.00 deposit prior to review. <br /> 6. 'TENTATIVE appointment dates must be confirmed with EM13 staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> LREVIEWED <br /> EL? APPOINTM ENT DATE TIME <br /> IRMED PHONE. FAX INITIALS <br /> YES NQ REVIEW DATE <br /> s <br /> TOTAL P.01 <br />