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6 -:VO .- <br />1 ., <br />'I. fn:� C. 1(,Utl ..+iu t v iw;Jucv; . <br />kkA; tdY6lT Gld6 6U(i M%M SEN <br />SAN AQUIN COUNTYPUBL-IC HEALTH -VICES <br />ENVIRONMENTAL HEALTH 01VISION <br />304 FAST WEBER AVENUE, THIRD FLUOR - rl <br />STOCKTON CA 96202 <br />(209) 4664420 <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICCAANTd 1�, �` (� � RRUSINEWIAGENCY M c. La��d. <br />ADOR"s 1110 W ►1i •1 T (}ACIL ice" lit deClkO COC C <br />Wh ! {l~ e 2C) <br />P110NE !2 05` 1- 1,26 ! FACSIMILE 916 - CA 3& -.-) 1RA-:1 <br />TENTATIVE* APPOINTMEW E3ATE /' 1 TIME a 5 ' <br />(Phease gVe T to 10 busi�iass days from date of applicaEon gubrnittai} <br />MAY 16-2000 J <br />Q CHECK BOX TO EVr;CM <br />3iGNATURE OF APPLICANT <br />FEE w REQUFA T PROCL65ED IN a suSIiESS BAYS <br />DATE S- �S-ate <br />T:+ <br />NtlMOROUKD TANK (LIST) CLEANUP SITE (LOP) O 1r=U5WG AOATEMENT D SOLID WA67E FACTLnY <br />d 01HER CLEANUP Sh•E II40e14MM Q FOOD FAt31-RY m sola0 wASTF YE}iiCL.E <br />►iDaWRt UND TANK pA ROIC rrlRAWAL) a KZNNM l eT DAIRY <br />* HAZARDOUS WASTE GF-NMTIDR to CHICKEN RANG" ® PKG TREATMENT PLANT <br />O TWKD POWnT'ER FACl1 W , 0 KOTWHOTEL O PUMPER ARB(CHEM TOII QTS <br />C► TATTOO15cay PEIRCING 0 POOU5FA 0 LPX0 LIGE APPLICATION SUM <br />Ei MEDICAL WASTE FACILITY O PuBur- WATEii SYSWM ❑ 0I'HI=R IPLME SPECIFY ABOW) <br />1. List up to ten addressers in the space above. Select the typo(s) of files from the list abave by checking <br />the appropriate bo x(e5). At least one flIe type MUST be selected- Fax to (200J 404 D-438 ar mail Mtn* <br />a��rass irudica�c� appye. <br />2. 9W will notify the applicant If any EHD files exist. An appointment for review will be confirmed <br />approximately five business days but no later than ten (10) days after receipt of application. Tho Ales <br />will be held for a maximum of five business days for review. Appointments should be scheduled <br />.a=ordingly. <br />3. A tile) that is .actively being worsted on by END staff may not be immediately available for review. A now <br />application may be submitted when the file) is available. <br />4. Any file not returned In Me same condition as released will be reoraanixed by EMD staff at the expense <br />of the applicant. Future Mite reviews by the sama applicant may require a $7M0 deposit prior to review. <br />6. wrENTATM appointment dates must b® c nfirmcd with EMD Staff. <br />6. Applications received after 3-.00 pm will be processed the next business day. <br />APPOINTMENTCONFIRMED DATE ir4 <br />DATE CONFIRMED 1. PHONE FAX INITIAI-S <br />0M, 141JAC <br />PFvsr-w nATt2 <br />