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SAk*AQUIN COUNTYPUBLIC HEALTNHMSERVICES 4+v 4G4 t1UM�� <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE,THIRD FLOOR (J/t 3 <br /> STOCKTON CA 95272 a <br /> or PUBLIC RECORDS RELEASE APPLICATION <br /> 4R1'JT BUSINESS(AGENCY .T <br /> FAMMARX <br /> TENTATIVE-APPOINTMENT GATE <br /> r (Pl0as.give r tp TO bus+ntsli days from date of application su6rn(ttiq <br /> s` <br /> ECK BCk TO EXPEOMY REQIJJ=3T-$78.04 FEE—REQUEST pROMSSEt)IIK 3 8UIi1MEsJ5 gAYIL <br /> TURF OF APPLICANT <br /> DATE + <br /> rpt FILE AD ESS <br /> 49 <br /> 140Lar <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> ENGROUND TANK(UbT)CLEANUP SITE(LOP) O MCXMING ABATEMENT O SOLID WASTE FACILITY <br /> Ek CLEANUPJirTE(NON-LOP) 13 FOOD FACILITY D 3OL10 WA8TF_VRk1CLE <br /> ORGROUNte TANK(U0NTT0RJ1VG/REM0%tAL) 0 DOG KENNEL O DAIRY <br /> OUS WASTE GENERATOR n CH1C.KAN RANCH d PKG TRrLATMENT PLAIT <br /> D PERA TTEC FACILITY G MOPEUNOTEL 13 PUNSPHRTROOMAR=HE>rl TOMXT9 <br /> DY PBRCING O POQL(SPA 8 LAND USE APPLICAT{gp)SriEa <br /> 40AL 1NdSTE IaACILTTy 4 PUBLIC WATER SV:S I M In OTHER(PLEASE SPECIFY ASOVR) <br /> List up to tell addresses In the spare above. 3010et trIG types) of Mitts from the list above by chaakinC. <br /> the appropriate box(es). At least one file typo MUST be selected. F'axta 1292 464•Q1S§gr �+►t,e <br /> aiddrage in ted above- <br /> EHD <br /> e_EHD will notify the applicant If any EHD fifes exist. An appointrnent for review will be confirmed <br /> approximately five business clays but no later than tern(10)days after receipt of application. The files <br /> will be held for a maximum of five busines$days for review. ApWntltrenta Should ba mheduled <br /> accordingly. <br /> A file that is gotiveiy being worked on by EHD stet!may not be iJo M*diat4IY avallable for review. Arra, <br /> 4 <br /> application may be submitted when the fila is available. <br /> Any file not returned In the some condition as released will be roOrgAnlud by EHD otaff at the expens. <br /> of the applicant. Future file Wows by the samo Applicant may require a$78.00 deposit prior to ravlm <br /> 'TENTATIVE appointment bates must be confirmed with EMD staff. <br /> Applications received after 3:00 pm will be processed the next business day. <br /> IMAE[i APPOINTMENT DATE -- r TIME <br /> 6 CONFIRMED PHONE FAX <br /> INITIALS <br /> ED YES NQ REVIEW DATE .. . . ... . <br />