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07 oa 03: 33p N"WA <br /> 95-e5----W0 n?:0`_�PrI FR019 <br /> SAN J0A0t,1lN COUNTYPUBLIC HCALTH SERVICES ,'u. <br /> ENVIRONMENTAL HEALTH DIVISION <br /> WrIII!, rot,1 304 EAST WEER AVENUE THIRD FLOOR <br /> STOCKTON CA 95202 DEC 0 7 2000 <br /> (209)4641-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION ENVIRONIAENT HL- 11 <br /> R 414SzR.\j('"S' <br /> ? NI BUSINESSIAGENCY 'En✓s <br /> r�� J1, Ei� .S er�t <br /> . ADDRESS � krwtr '7 �p 1 <br /> C ,4 <br /> 33 <br /> TENTATI VE'APPOINTMENT PATE_/ ✓r Z (y>d �vl L:` r <br /> (Plvaxe vivc 7 to 70 Gualnes5 Oa S tr £ <br /> om date of applk4tfonAft <br /> submlteall �� "y ,r <br /> CHECK f30X To EXPEDITE REQUEST- Q pp F _REgU PR CESSEt?1#13 BUSINESS DgYS \' ' <br /> SIGNATURE OF APPLICANT <br /> DATE_ f 7 <br /> FILE ADDRESS \/� THIS SIDE FNO STAFF USE pAJLy ' <br /> ��lJ PROGRAM ELFhW;M6 SEARCH <br /> 2.3 xrr r <br /> Lo �I � I <br /> 3Sa8K <br /> ENVIRONMENTAL HEALTtI DIVISION FILES <br /> UNDERGROUND TANK(t1ST)CLEANUP SITS(LOP) r1 HOU&MG AGA-fV9tNT <br /> E3 OTHER CLEANUP SITE(NON.LOF) SOLID WASTE FACILITY <br /> gUNOERGRCIUNDTANK(NIONrrOR1?tGJREMOVAL ❑ F04DFACIUTY p 0 SOLID WASTE VEHICLE <br /> HAZARDOUS WASTEGENCRATOR ) ❑ 006 <br /> CKEHNEREL 0 DAIRY <br /> ❑ TICRED PERMITTED FAcU.IT'Y PKG TREATMENT PST <br /> ❑ TAT-roofuODY PEtRCING 0 P��AOTCL 17 PUMPER TRUCK YARWCNFAI TORTS <br /> ❑ MEDICAL WASTE FACtuTY C2PUBUC WATER SYSTrLm O OTHER PLEASE P C0 LAND USE. 01FY A8 VO E) <br /> 1. List up to ten addresssss in tho$Paco above. select the type($)OT rites from thtt list above by checking <br /> the appropriate box(es). At least one file We MUST be selected. Fax to 2OS 4 -013 mail the <br /> address indicated above <br /> 2• EHD will notify tltt apptiCant if any END files exist. An <br /> appointment tor=view Ll <br /> approximately live business days but no later than ten d)days after receipt o ajpplic!application. The files <br /> will be held for a maximum of flue business,days for review. Appointments Should be schedt,led <br /> accordingly. <br /> 3_ A fele that i9 actively being worked On b END staff ma <br /> Y y not be immediately avdilabfe far[eviow• A nOW <br /> application may bre submitted wizen the fits es avaltabl4. <br /> 4. Any WO not returned in the Same condition as released will be reorganized by END staff at the Qxpense <br /> of the appliCanL Future rile reviow4 by the same appticant may require a$78.00 deposit prior to review. <br /> y- "TENTATIVE appointment dates must be confirmed with Flit?staff, <br /> 6. Applications received after 3;00 Pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATECONFIRMED <br /> PHONE FAX <br /> INITIALS <br /> REVIEWED YES NO REVIEW DATE~ J� Oi'iM01 <br />