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i r,y xe xlve UM iuu SWilliK <br /> SAN JQf IIN COUNTYPUbLIG HEALTH bk~R ' =5 � n <br /> E;. .IRONNIENTAL HEALTH DIVISION <br /> 344 EAST WEBER AVENUE,THIRD FL06R <br /> STOCKTON CA 95202 <br /> (209)468-3420 <br /> _ PUBLIG RECORDS RELEASE APPLICATION <br /> ,' 1 � Jac <br /> � <br /> 'VPI-1CANT 1__ � ; )) OUS1NkSUTAGENCY <br /> AnO�Ess TSU <br /> PHONa FAC91htlLE <br /> TENTATIVE"APPOINTMENT DATE _ r,TIME <br /> k <br /> (Please fl(vq 7 1a 10 1;usincs3 daysfrom Cato of rtpplicat oauCmlttal) <br /> Q GHECX BOK TO LXF'EUITF_KE UE3T a-00 FEE-REQUeS r PROCESSED IN 3 BUSINESS DAYS <br /> LSIGNATURE OF APPLICANT DATE <br /> FILE ADDRESS THIS SIDE WiD STAFF USE ONLY <br /> PROGRAM XL_RMENT3 SEARCH <br /> Lou L <br /> Cllr `s 7, C7T V i <br /> N 7q5 F(� CU o I <br /> *'N51? FA U L- 4- O • <br /> NFF _ N0 <br /> 5 -00 -A (:t'OSy 13 I <br /> J U L 17 2000 <br /> ENVIRONMENTAL HEALTH DIViS10N Fil ES <br /> ERGROUND TANK(U$T)CLEANUP SITZ(LOP) ❑ HOUSIwG AgATEMEN, WASTE rACILITY <br /> ER CLEANUP SITE(NON-LOP) C r00V FACILITY �, ID WANE VEHICLE <br /> DERGROUNI)TANK(MONITORINCLRLMOVAL) C3 D04 KENNEL O DAIRY <br /> RD"S WASTE GENERATOR 0 CHICKEN RANCH l7 P G TR"TMF-NT PLANT <br /> FRED PERMITTED FAClLlTY <O MDTEUHOTEL �+1PERTRUCWYARDICHP.MTOILETS <br /> TATT001aODY pL�IRCINQ OOt15f'A D USi=APFUCATtDN 91T>?5 <br /> d MEDICAL.WASTH FACILITY PUPUC WATER SYSTUM OTHE �CI>'Y AHOYG) <br /> 1. Llst up to ten addresses In the space above. Select the lype(>z)of fi s from the.list abo y checking <br /> the appropriate bOY(es). At least one file type MUST be selected, F ° <br /> address indleatld.AbOYO <br /> 2. 1:HB will notify tho applicant if any EHD files axitt. An$ppointment for re Q Confirmed <br /> approxirnatsly five business days but no later than ten (13) days attar recelpt of application_ The fllea <br /> will be held for a maximum of five business days for roYlow. Appointments should be scheduled <br /> accordingly. <br /> 31 A file that is actively being worked Dn by EHD staff may riot be Immediately available for raview. A new <br /> applJostion may bQ submitted when the file is avallable, <br /> 4. Any fila not returned In the Game condition as released will be reorganized by EHO staff at the expense <br /> of the applicant, Futuro file reviews by the some applical It may require a $78.04 deposit prior to review. <br /> 5. 'TENTATIVE appointment date; must baa Confirmed with EHD staff. <br /> 6. Appiloatlona retched after S:00 pm will be procowbed the next business day. <br /> CONFIRMED APPOINTMENT DATE _ TIME <br /> L' TF CONFIRMED PHONE FAX INITIAL$ <br /> kEVIEWED YES NO REVIEW DATE <br /> » :+ <br /> TBTAL P.Oi <br />