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OB:08AN FROM � TEL:20� 514 � P. 00$ <br /> DATE*kCEiv@p TO <br /> 5 '41 Y <br /> { S 10AQuiN COUNTYpUBLIC H ALTH SERVICES <br /> a ENVIRONMENTAL HEALTH D <br /> 304 EAST WEBER AVENUE.THlI2D olpR <br /> j <br /> STOCKTON CA 95202 <br /> I 20$) i 1 r'•I r <br /> PUBLIC RECORDS RELEASEAPPLICATION Ly <br /> APPLICANT <br /> d`' /v7 SUSINE$VAGENCY _5Vq' <br /> AbORESs Aa.'� Ql -. 1. <br /> PriONE 2d a _� � I <br /> FACSIMILE S74! y <br /> F <br /> ' TENTATIVE APP0JNTMLNTDATE 7S`2{—Qts <br /> TIME F'G/a ... <br /> (Please glVp 7 to 10 6V3meS5 days trvm date Of application submittal} <br /> "' &'ECK 13OX T EXpeorrE REQUEST-587.00 FEE .REgUEST <br /> PROCESSED 1N 3 9LISINE55 DAYS <br /> SIGNATURE Cf APPLICANT � <br /> DATE <br /> II <br /> mi FILE,ADDRESS <br /> II Tiilfi SIDE EFfD STAFI USE ONLY <br /> ii 5;f-5T PROGRAM ELEMENT'S SeARCrt <br /> ii <br /> 11, <br /> i u ) <br /> ENVIRONMENTAL HEALTH DIVISIGN FILES <br /> JA4pERGIROUND TANK(UST)CLEANUP SITE(LOP) M HOUSING <br /> ER CLEANUP SITE(NON.LOA) ❑ Fgp4 FACILITYABATEMENT ❑ SOLID WASTE FACILITY <br /> _ <br /> "ER <br /> TANK(MONrMRING&emOI ❑ DOG KENNEL ❑ SOLID WASTE VFJ-11CLE � <br /> HAZARCYOVS Y1r. .STE GENERATOR 0 DOG KMCKN EL ❑ DAIRY <br /> TIERED PF MIT�p FACILITY ❑ P>EG TREATMENT PLANT <br /> ❑ TATTD41BaDY PEIRCING ❑ 6AOTELIHpTEL 0 PUMMR TRUCKlYARDICKEM TOILETS <br /> ❑ tit1=p1GAL WASTE F}tGIt,rry ❑ PUOLlSPA r] LAND USE APPLICATION SIZES <br /> 0 PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFYAaOVE) <br /> 1- List up tp ten addresSeS in the space al3ove. Select the type(s)of hies from the lisle dlapve by Checking <br /> the appropriate box(es). At least ane file typ,�MUST be selected. Fax to 2d9 464.0135 or <br /> addre in is aci above. lI to tha <br /> ?. EHD will notify the Applicant If any EHD files exist An a <br /> appraxirn°atety five business days but no later thane ten{110)day$affor <br /> r receipt of 1pplicatil be oR�h files <br /> i <br /> Will be hild for a maximum of fire business days far reView. A <br /> accordinhly. ppaintments should be Scheduled <br /> 3- A file that is actively tseirtg WorkQd on b staff may- <br /> aWlcatiarl may be submitted when the f le is im <br /> va abble. not be rnQdialtely avaiiat�le for raviaW. Anew <br /> 4 Any File not retUmecr In the same condition as released will be reorganized by EHD staff at the expense <br /> OF the applicant. intureme fila reviews t the same aPPliCent rmn require a$87.00 deposit prior to review+. <br /> 5. `T>;N7ATr1Ir=appairrtment dates mus#tsa confirmed with EHDs <br /> 5, Applications received after 3.60 pm will taff, <br /> be processed the next business day. <br /> i <br /> CONFIRMED APPOINTfOENT DATE <br /> TIME <br /> DATE CONFIRMED . <br /> i PHONE FAK INITIALS <br /> Mt;VIEWED YES ------- --�� <br /> REVIEW[TATE <br /> .i <br /> i� <br />