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'02/24/2012 08:35 <br />�ay4 <br />FEB 2 A 2003 <br />7146711 ESS <br />-6410_6 cr4%• Lr%us »u•r M� rr <br />SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />;304 EAST WEBER AVENUE. THIRD FLOOR <br />5TOCKTON GA 95202 <br />(209) 466.3420 <br />PUBLIC RECORDS RELEASE APPLICATION <br />PAGE 02 <br />EN <br />�.ifjo <br />l.) t'd-- <br />AP'PLICA14T— _ . _ <br />AUDRLS5: <br />PHONE / -1 / 1-_- 3 67 -- __ <br />%NTATIVE• APPOpiTMCNT VATt:Aft <br />—-_-._--- ____ TIME ..._ • <br />(!>leaao olva 7 In 9U business days from date of sprlUc:lltorl ilj tntttat) • <br />N'SS CATS <br />® CHGCK bOX '0 EXI pDITE REQUr.S • St19.00 I•lG - RE -QUEST PROG65SED IN RUST L 2,2 <br />DATE <br />SIGNATURE OF APPLICANT _ . �,2 _•� -- �"� ""' <br />-_-� <br />-tpg Sfo�,iS'rAFr- u8C bNLY <br />AD MESS' prto ottAM rt j:MCMT6 cn.AR %H <br />ENVIRONMENTAL HEALTH DIVISION FILES <br />-1 p HOUSING ABAT6MCN7 0 SOLID WASIC PA(;ILITY <br />V 'JNt71:RrftOUND TANK (UST) Ct-EANUh "ITC, (LOP) FACILITY t7 SOLIt1 WASTE: VEHK;LL <br />O FOOD <br />OTHER CLCANUP SITE (NON -LOP) IL d oAIR'Y <br />UNUCRonoUNd FOOD FACO TANK (MONIroTtL4wREMOVAL) 0 CHICKEN EL 0 PKG TREATM I4"T pt AN't <br />HAZAADOU3 WASTt' GFNE"ATOrt 0 MOTELIHOT$L a LAN* a TRUCKf7/ TION X"T r01LE'r <br />0. TIERED PBRk►r Tao PACIUTY b POOLAP1% (] LAN* U5G ZjCjAl"VILICATI IF ASO <br />0 T•ATT001130OY Pt-IRCING 0 pUDLIC WATt:R SYSTEM L3 VTHLk IPL�lSL' SPtCIFY AetOvEl <br />Q MrDICAL WASTE' FACILITY •. • . <br />�� ag•4p01 ar maf6 lt!e <br />1 t tst up to ton addresses In tha space. abovq. Soleact the type(s) 0.f 111cs from the lint above by chocking <br />the 1pprovrfatc box(cu). At leaSt 0.110 filq typo MUST bo suloctod. Fax to f) �$ -.--- •-�---•- <br />:Id(iresS indicated above,fnont for review will be confirmed <br />Z. EHD wii) notify the applicant i1 anY E 1 <br />an 1® days attar re»e{p ot appHD files exist. An (oint11r i(i®n. The (i1C5 <br />approximately five business days bUt no later than tt <br />will be !told for a m:txlrnum of five business days for review. Appointments should tic scheduled <br />accordingly. <br />3 A rite. that is actively bc:n0 worked On Dy wHD %tall may not be imrttedlately ava�t.lh:e for review. A now <br />appllcatloM may b,= submtttod when tho 4110 {s rajasavallbio. <br />q. Any rile not returned Ih th0 sAmo condition as re ldased Witt be reorganized by ENQ st.,fP :!t the expense <br />of the applicant. Future ilio rovIews by the same applicant maY require a $30.00 deposit prior to review. <br />g. °TENTATIVE :tpppin;n,cnt dates must oa r:onfirmod with EHO staff. <br />(;, Applications received arlef 3.00 pm will be psocossvd the noxt brusfne5S day. <br />CONFIRMED APPOINTMENT DATE _, TIME <br />PHCNF FAX INITIALS i <br />14 DATE= CONFIRMED - -------- i <br />. REVIE-WER YES pare REVIEW ikAt'F____� <br />