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SAW,�QUINCOUNJ-YPUBb HLAILI-HN -5 <br /> L-D) <br /> E-7 ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WES ER AVENUE, THIRD FLOOR <br /> FEB 5 2001 STOCKTON CA 95202 <br /> (209) 468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> PF! vw's ?`Flr ; � 11 <br /> .A USINESSIAGENCY adf)04C <br /> il-6�:�4�1- <br /> -5-- /0, a),/ So QJri <br /> PHONE 7��D-9) z1k.-2-106&FACSIMILE- '7 11(9 <br /> TENTATllVr=*APPOINTMENT DATE aGO&LIVLS)TIME I D•O 0 <br /> (Please give 7 to 10 bList"sr,days from date of applirAtIon submittal) <br /> CHECK BOX TOEXPEDITE REQU 'I-U4?-tQFEE—REQ BUSINESS DAYS <br /> SIGNATURE OF APPLICANT %T DATE 5 f �/ <br /> FILE ADDRESS <br /> q I Y�t�P r <br /> 14200 (nllr nrT LLk i. <br /> 210 9 S (I [A L4 <br /> 1?3 e 00 ir jjj�,-F Res I A-0-Aces <br /> ILI <br /> cl L4 <br /> I Y 917#7 <br /> !R 2 P, 1- 1 <br /> Sq ` <br /> ENVIRONMENIAL HEALTH DIVISION FILES <br /> UNDERGROUND TANK(UST)CLEANUP si-rrz(LOPJHOUSINO ABATEMENT 0 SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NOWILOP) 1�FOOD FACILITY 0 5000 WASTE VEHICLE <br /> UNDERGROUND TANK(MONIYOFIINGIREMOVAL) 0 DOG KENNEL 0 DAIRY <br /> HAZARDOUS WASTE GENERATOR M CHICKEN FANCH 1:1 PKG TREATMENT PLANT <br /> O TIERED PERMITTED FACILITY M MOTELIHOTT=L 0 PUMPER TRUCKfYARDICHEM TOILETS <br /> TATTOOtSDDY PEIRCING 0 POOL)SPA M LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY 0 PUBLIC WATER SYSTEM = OTHER(PLEA5E SPECIFY ABOVE) <br /> 1_ List up to ten addresses in the space above. Select the type(s) of files from the list above by checking <br /> the appropriate box(es). At least ono file type MUST be selected. Fax to (209)464-0.138 or mail to the <br /> address indicated above. <br /> 2. EHD will notify the applicant If any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten (10) days after receipt of application. The files <br /> wilt be held for a Maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that iz actively being worked on by EHD staff may not be Immediately available for review_ A new <br /> application may be submitted when the flie is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a $78.00 deposit prior to review. <br /> 5. *TENTATIVE appointment dates must be confirmed with EHL) staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> EH OR 14 DIAS= <br />