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DATE RECUITC V 1 / .E11t�It�7G NUMBER <br /> SAA AQUIN COUNTYPUBLIC HEALT _RVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 344 EAST WEBER AVENUE,THIRD FLOOR nn�1•(1 <br /> STOCKTON CA 95202 <br /> (2ae)4$8(209)468-3420U APR 7 �UoU <br /> PUBLIC RECORDS RELEASE APPLICATION �'in r.fr T <br /> PF" ices <br /> APPLICAN ��,rL/ /.� /1�' sUsINESSlAGE1�cY �f /�tl� Gt� _ <br /> ACORESs 1, <br /> PHONE ��7Z�7�7 "7�7��0�•��� FACSIMILE <br /> TENTATIVE-APPOINTMENT DATE TIME <br /> (Ptesse give 7 to 10 business days from date of a;;Mioadon Submittal} <br /> CHECK SOX TO EXPeDITC REQUEST-$78.00 FEE-REQUE5T FROCESSFD It 3 BUSINESS DAYS <br /> SIGNA'T'URE OF APPLICA DATE <br /> 67 <br /> FILE ADDRESS <br /> a. q 1i d <br /> 'Cif 41 Z22L9 qa a S <br /> 3s1 P39 9S <br /> .0 I(tlCo 2 � 0 3 5 2 <br /> ► 2 0 f 3 ��S <br /> Oe <br /> ENVIRONMENTAL HEALTH DIVISION FILES APR 12 2000 <br /> fi <br /> NDCRGROUND TANK(UST)CLEMUP SITE(LOP) Q HOUSING ABATEM@NT SOLID WASTE FACILITY <br /> THER CLEANUP SITE(MON-LAP) b FOOD FACILITY O SOLID WASTE VEHICLE <br /> NDERGROUND TANK(MONITORINGfREMOVAL) 0 DOG KENNEL D DAIRY <br /> AZ.AtzAOUS WASTE GENERATOR fl CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> // L MD PERMITTED FACILITY 0 MOTELINOTEL 0 PUMPER TRUCKJYARDICHEM TOILETS <br /> O TA'ITOOISOPT PEIRCING 0 POOLISPA 0 LAND USE APPLtCATEON SrTE!s <br /> 0 MEDICAL WASTE fACILfTY 0 PUBLIC WATER SYSTEM 0 OTHER(PLEASE=SPECIFY ABOVE) <br /> 1. List up to tan addresses in Vio space above. Select the type(s)of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(209)45!L-S 1� 38 or rtaggil to thla• <br /> address indicated above, <br /> 2. EHD will notify the appfiount if any EHD tiles eXISL An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10)days after receipt of application. The files <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 being worked on by EHD staff may not be immediately available for review. A new <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 EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a$78.00 deposit prior to review_ <br /> S. '"TENTATIVE appointment Gates must be confirmed with END staff. " <br /> f3. Applications received after 3:00 pm will be processed the next business day, <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> Ete ag Ie evosm <br /> TOTAL P.02 <br />