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V�v <br />f' c 1c:Jv rnA .Yeo tivo 0400 n1:O L"-YrrtR.1.V♦ ...LL%.%, <br />07/22/£nnLlI h:UU 464@138 ENVIRU4EIJAL FEALTH <br />�i 4 •__V•�I1I�I <br />�N JC )UIN COUNTYPUULIC HEALTH SE ICES <br />ENVIRONMENTAL HEALTH DIVISION <br />v 304 EAST WEBER AVENUE, THIRD FLOOR <br />STOCKTON CA 95202 <br />(209) 4683420 <br />��UBLIC RECORDS RELEASE APPLICATION <br />PAGE 01 <br />PlO `OG NUI.BF]1 <br />1116� yo <br />Z9 <br />APPLICANTS'.hC44 LI14V11P1-- SUSINESSIAGENCY 'W es�-on 5����io✓ts, �(,t�c . <br />T <br />ILA <br />S'01 <br />PHONE -1'LS -19 -1 FACSIMILE Q'2 CJ �7'-iS "[O`}6S <br />TENTATIVE" APIPOWMENTDATE �I30/02 TIME 10; 0� 4w� <br />(Please Me 7 to 10 business fm date of a Icatlon submittal) <br />��� P o s� r•��A!kIs <br />0 CHECK BOX 70 E7(PEDITI? REQUEST -509.00 FEE -REQUEST PR EDI 0 BUSINESS DAYS <br />SIGNATURE OF APPLICANT <br />DATE <br />• . <br />IV • � Jl • [• <br />a•-IIIIIIIIIIIIIIII,�I"II- <br />f. .�. <br />IIIIIIIII����IIIIIIIIIIIIIIIIII, <br />-- _ <br />nri�,�n1111C�11T�C�111�� <br />AINIMl1'�IIICr11�1�U�1!•� <br />IME `"+'iYiilii�� <br />-.• <br />3 ?,N <br />ENVIRONMENTAL HEALTH DIVISION FILES 11 `i <br />UNDERGROUND TANK (U911 CLEANUP SITE (LOP) O HOUSING ABATEMENT X" SOLID WASTE FACILITY, <br />OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACRIIY ❑ SOLID WASTE VEHtCLFj'y" <br />UNDERGROUND TANK (MONMORiNWREMOVAL) ❑ DOG KENNEL 0 DAIRY <br />HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLAA'{'Y. <br />TIERED PERMITTED FACILITY P MOTELIHOWL d PUMPER TRUCKrYARftAEM TOILETS <br />❑ TATTOOIHODY PEIRCING ❑ POOVSPA ❑ LAND USE APPLICAT)U61 SrrES <br />❑ MEDICAL WASTE FACILITY ❑ PUBLIC WATER SYSTEM ❑ OTHER (PLEASE SPECIiI.Y ABOVE) <br />1. List up to ten addresses in the space above. Select the typ(s) Of files from the list ab6Ve by checking <br />the appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0138 email to the <br />address Indica ted above. .1 <br />2. EHD will notify the applicant if any EHD files exist. An appointment for review will be 6df07ned <br />approximately five business days but no later than ten (10) days after recelpt of appllcaNn. The flies <br />will be held for a maximum of five business days for review. Appointments should be S."eduled <br />f. <br />accordingly. <br />3. A file that Is acl'.ively being worked on by EHD staff may not be immediately available ftWToview. A new <br />application may be submitted -when the file Is available. <br />4. Any file not returned In the same condition as released will be reorganized by EHD slafhat the expense <br />of the applicant, Future file reviews by the same applicant may require a $B9-00 depogit prior to review. <br />5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br />G. Applications received after 3:00 pm will be processed the next business day. <br />CONFIRMED APPOINTMENT DATE. <br />DATE CONFIRMED <br />REVIEWED . YES <br />TIME <br />PHONE FAX <br />NO REVIEW DATE <br />INITIALS <br />