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SAN ,JOWN COUNTYPU13LIc tirzALTH S*CES <br /> vim, NVIROI�IM�NTAL HEALTH i7tiJtSiC[ <br /> Pig. - ` 2001 304 FAST WEBER AVENUE,THIRD FLOOR <br /> STQCKTON CA 05202 <br /> (209)458-3420 <br /> r PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT H 3iHESS1aGENCIr . T <br /> APPREss <br /> PHONEl LLQ 4 111 FACS041LE D � <br /> TENTATIVE"APPOlN*tMEN'T RATE <br /> (Please give 7 to 1 D r,ysh►ess tlays Pram+! �t pl <br /> 70 <br /> Q voff- <br /> CHECK 90TO ExPEpi a iff" -s87 F�— EST PF -V IN 3-HUS9451 S BAYS <br /> SIGNATURE OF APPLICANT DATE . <br /> FILE A[1RR THIS slog EHp STAFF i7SE ilNLY <br /> l PROGRAM Rt--MENT4 SEARCH <br /> h Fs: <br /> Y r <br /> ENVIRONNEI+ITAL HEALTH OMSION FILES <br /> I�PNNIQFAIBROUNIQ <br /> RFRGRQWh0 TANK(U�?cug �luP SITE(LOM Q 1i�illull+IG AR TEJif:NT SfiUo WASTE FACtt.P[Y <br /> tiCl-FANoAM(MCgLflPI C1 FOOD FACUZTY g.Ql.lp WASTE VEWCU TANK{MOI+IFiOF?JN�IF�EA�S7VAL) C! DCG KF.NNM Q pafRY <br /> sChAZA DOLM WAST£ iial�i woe 1� <br /> Q TiERrm PERMF TEci FA.C1t-!T1( M MOtTEWWTF-4 M PKK TREaTMFNT ALAw <br /> IP TATT001800YPORCOic; A PUMPER TRUCr4YARWCHEa1 TQLr-M <br /> 0 MEDICAL WASTE FACiLffy � POQ#JSPA q LAND USEAPp1-ICAYi0X S$TEs <br /> A I'U0LX WATER SYSTEM M OTHER(PLEASE SPI=CIFYAt$OVEI V i <br /> i. List up to ten addrt Sum in the space above. Select the type(s)of files from the list above by checking <br /> ttw apprOPriate boy-(es)- At least one fife type MUST be selWed. Fax to( g� <br /> address in -ccated dvg r-_.�.t2r ffi>�il-LD The <br /> 2. EHD will notify the applicant iT any EHp ffles exist. An appoiiltrlMent tar rsvi@w will ata r-Qnflrmad <br /> approximately five bulsingar.pays but no latef than tett(JQ)aays after receipt n#appltcatian. The�(es <br /> will r held for a maximum of five business days for review. AppointmanW should be scheduled <br /> accortiinS(y_ <br /> 3. A file that is Acutely being wprketf on by F-HD r>taff may not be immadiaWy available for r�vlew. Anew <br /> application may be submitted when the file is available. <br /> 4. Any file not tetumBl in the tame condition as released will be reorganized by EHD staff at the axpettse <br /> of the applicant. Ftiture fie reviews by the same applicant may require a$8T.QQ deposit prior to rsvle e <br /> S. 'TENTATIYI=apP0lntr 0n1 dates f1'IUSt be confirmed with EHD a4ff. <br /> 6. Applications receiued after$:QR pm will be prQcessed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> nr3,r1r34=^ Vt"S pin <br /> R;:1J1>`w i'7ATF <br /> UNIT 11 - rQAv-Q,0 t- y�s�ot <br />