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L-1%J v i r-%Ui i,,!�L3,t I <br /> r I-A-il"i 1 <br /> CNDLu"7 2(Aorl <br /> SAN J0 ofN COUNTYPUBLIC HEALTH SERVICES` <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 3(X EAST WESER AVENUE,THIRD FLQOX <br /> AM 0 <br /> STOCKTON CA 2=92 <br /> (209)463-M20 <br /> q. kR <br /> PPBLl RECORDS RELEASE APPLICATION <br /> SUSMESSIAUENCT <br /> 5 <br /> 1� -3 (,,r, FACSWILF 157* L%f2-& <br /> 'T, g <br /> TENTATIVE*AppoirrurtiT Pwm <br /> tfleaw girt 7 to 10=-4WST.Gaya frWn"Q CJ-VP51:4k(1DA S"bMAtif) <br /> CHECK BOX TO EXPEWTE REIQUET'S8 FE;F--RE(3UPTPROCIESSEDIN31SUSLWSSIDAVS <br /> SIGNATURE OF APPPATELICANT �Z, L <br /> rrs M S;ar;CHH$,TAFF V�F.otay 7 <br /> 7117 <br /> -7 <br /> 6.S &--.A4 t <br /> T <br /> 73J <br /> iNVIRONMENTAL HEALTH DIVISION'FILES <br /> tVADERGROU NO TANK{UST)CLXANUP 3jrTE 9,QF) 0 HOUSING ABATEMENT 0 SOLID WASTE FACILITY <br /> THERCLEANUP SITE(MO"o) C3 FOOD FAGUJTY 0 SOLID WASTE VEHICLE <br /> urivERGROUNQ TANK WNlT4DR1t*G0R1rU0YALJ 0 DOG KENNEL C1 DJURY <br /> KAZAFEPWS WASTE GEREAA'rOR (3 CHICKEN RANCH C] PKG TREATMENT PLANT <br /> —14, 0 PUMPER TRtlCKJYAR=HENT1DkLET3 <br /> a TIEREu PEmnTap fAULfTY 0 M0T"qT1VL <br /> C TATTQI�fslDuy FZIKCING 113 POOUSPA - - C3 LAND USE APPUCAT*K SITES <br /> C MEDICAL WASTE FACUM i In PUBLIC WATER SYSTEM 0 OTHER(PLEASEUPWFY ABOVE) <br /> 1. List upto ten addr6ses in the spaveaJiOve- Select zahlctYPe Of files from U"Inst above by chocking <br /> the appropriate boz(es). At least one file type MUST be Wetted. Fax toL209)464 138ormaUtotht, <br /> ad ress indicated <br /> 2. EHD will notify theopplicaht if arty EMD files exist. An-appointment for review will bo confirmed <br /> approximately fiYejbus;jness days but no Later man ten(10)tays after receipt Of 2PPlicaUon.'The lifer <br /> w1J1 be held for a rrkaxirnuml of five business days for review. Appointment$should be schedwied <br /> accordingly. <br /> 3. A file that is attiveV belng4arked an by EHD staff may not imme4iaWly wMilable fur rcyicw. A new <br /> applIcation may"subrahked Wh6A the file Is available. <br /> 4- Any file not fOtUrrWd in thn S Condition as rol4muVwd YwAll reorganized by END staff at the expense <br /> Of the applicant. Fb1i.1re file View=th*carne applicant ay require a$87.00 deposit prior to mvieW. <br /> B. ITENTATIVE appolntMent ilates must be confirmed Wftffih F-,Jstaff <br /> 6, Xtbusinessday- <br /> CONFIRMED Appommiva DAF- TIME <br /> DATE CONFLRMED i PHONE FAX 4NITIALS <br /> REVIEWED YES i ria REVIEW DATE <br /> TOTPL F.01 <br />