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Or <br /> if �y.� �Ht:Lbw.,lluen.�cu <br /> E SAN JOAQUIN COUNTYPUBLIO HEALTH SERVICES <br /> APR - 5 Z01,1 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> } <br /> 04 EAST WESER AVENUE.THIRD FLOOR <br /> STOCKTON Cil 55202 <br /> 209)488-3420 >� . <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> }I 'PL_ICA � le. <br /> 5-- u l n P r SUSINMIAGENCY <br /> $8 ) <br /> plaos. t ') � ` a fit` FAcsrHIIL t;__ _..,_ �?z --- -- - -- "'�` <br /> } 4 A (► fry j.': <br /> :•''"F IwNTATWE'APPOI.724ENT DATELl� <br /> ',''��,�.. iF'ft35�give 7 to 15 bus:[7' days Yra dr�4FAppGc�avn sc.6rrs�li�4 <br /> %CrncCK BOX►o EX?FDjTE RF-QUEST-537.09 i3 EE-R.EC JI ST PROCESSED W 3'EUW14ESS DAYS <br /> SIG14ATURE OF APPLICANT ., s= ,� f/ QATF_ <br /> i ly <br /> F1L_S ADDRE55 THLSi SIDE Etiv fiT AFF usF d&r, <br /> PROGRAM ELF-UE11TS SEARGM <br /> 36 <br /> f l _ <br /> ENV)R0NMENTA1_ Hr-A1_TH Q]YISION FILES <br /> UNDZRGRIOUNC TANK JUST}CL OAIjUp SLTP-(LQF� Q HOUSING AF$ATEMZ-"-r :p i~1 SOLID WASTE VEalcFA TY <br /> Ci F44p FACILITY LI SOt-LO WASTE V=HIGI.>r ' <br /> M OTHER CL.S<ANUP arre iKQ1J-LOP] Ca G KENNEL. GS DAIRY <br /> L1tlb1 RGC{alttiD rAtltC(NI41+iriGirlliGfRE1 VALj 0 CHICIXEN RARCH Gl PKG TRfrATIAL-12T PLAH-r <br /> H,%Z RDOUS WASTE GEi:_RATOR 0 PLIPAPER TRUCKryA9DjCtlE14T TOILETS <br /> D PF_FcM1 i rSD FACII iTY t C] P0TEUHOtEL <br /> m TizRE .j <br /> C7 OOLJSPA ,p '+� L.Ai3G USE APPLICATION 317>�S <br /> ❑ TAT-1•OV50DY?EtRCIWGi C7 pl1 f L 1G WAGER S I STt:DA 0 OTHER(PLEASE SPECIFY ABOVE) <br /> 0 A'Il:D1CIiL.WASTE FACILITY <br /> 1, List up to ten addresses in the space a5ave. Select tate type <br /> of tiles from She list Above by checking <br /> j the appropriate boz(es). At least one fele type MUST be selected. f=ax to x0'►)„46�-�'i 8 ar mail to the <br /> r <br /> gidress indicated above_ <br /> ' 2_ €H1rD will notify the a�piLcatat if any r=f4D files exist- An aPpointinent for'revieW Will be confirmed <br /> approximately five business days but na later than tan(10)Mays after receipt of afaplicatian- the files <br /> { will bR held for a nlaS fth=of five business days for feviOVY. Appointments should Ile scheduled <br /> accarciingly. <br /> 3. A fife that i5 actively being Worked on by 040 stsff may not be iorunediately aVailaiafe fnr vevlew_ A new . <br /> appiication may be s�lbmitted when the fide is available. if <br /> a. Any fele not returned�in the same condition as released willibo morganixed by EHD staff at titre expertise <br /> da tha apPrcanr_ Future file reviews by the same applicant inzy require a$37.00 deposit prior to reView. <br /> 5_ 'TEN TAT IVF, appointment dates R'mu"A be conflzmed with EHD Staff- <br /> 6. Applications reCeived after 3:00 PTOWill be Processed the next business day- <br /> , .F - <br /> �i <br /> CONFIRMED APPOINTMEUT DAVE TIME <br /> it <br /> DA i F-GaNFIRMED PHONE !'FAX INITIALS �- <br /> eij <br /> I REVIF-WED YES NO REVIEW DATE <br /> TCJTA4, P.011,H oo Ra .1WI 6 <br /> i <br /> f <br />