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ea-i5-2aai ra3�s�:-:-- i To t5zss3�sz N.©i <br /> �� r�;ycccrrveo _ tl+[I WGwurue+� <br /> SAN JOAQUIN COUNTYPUBUC HEALTH SERVICES 1 <br /> ENVIRONMENTAL HEALTH DIVISION y <br /> j <br /> 30 <br /> APR Z 7 ZOO1 4 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 962x2 <br /> (208)463-3420 r <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> F_ 7 <br /> ArPucA:rY� yL6kT//4 CV/P�97J9-N7B <br /> tUSIra =A6ENCY qe�q c <br /> ADORE-- <br /> PHONE �Z.s - �]V� ® 3L FAGSINInnLE_292-r/ - d- 9632 ,F7 <br /> TENTATIVE'APPOINTMENT DATE � C� T � t— TIME <br /> (Pisa*give 7 to 10 nus Vis"days from data of application sub nittat) <br /> I ❑ CHECK BOX TO EXPEDITE REQUEST-� 67.00 FEE OC!'S�1 BU ESS DAYS / <br /> SIGNATURE OF APPLICANT 6//�/C. V�� DATE T �7 'Q _ <br /> 17) <br /> FILE ADDRESS THIS SIDE EHD STAFF USE ONLY <br /> PROGRAM ELEMENTS SeARCH <br /> d r L 6 2 3ko 38/ o Z zv 9 S o <br /> 2 D 0 2 SI o 94 20 Z2 <br /> Z <br /> 0 O <br /> ctuCr AV fF 4(-o0r 9S N <br /> d TPI CLOU40 I) <br /> O CXD S7 T E 03) r 9 2 C.0 2 6 <br /> / K D T, f 8/ 9 3 0 <br /> 1 r C c S 3 80 38/ <br /> 57-QC K S2 ® o .2300 �3 <br /> i <br /> ENVIRONMENTAL HEALTH DIVISION FILES 'I�r�n Anil <br /> >� NDERG ROUND TANK(LST)CLEANUP SITE(LOP) ❑ HOUSING ABATEMENT &SOLID WASTE ill IL`s', <br /> HER CUANUP SITE(HON-LOP) ❑ FOOD FACILITY ❑ SOLIDWASTE <br /> I UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY MAY - C <br /> I VATMDOUS WASTE a£ ERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> I TFRFDPERMITTED FAC LILY ❑ MOTELHOTEL C3 PUMPER TRUCWYAROlCKLLI TOILETS <br /> PATTOO/GODY PETRCIHG D POOLISPA ❑ LAND USE APPLJCATToN SITES <br /> FAICAL WASTE FACILITY 17 PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> • I List up to ten addressas In the space abovo. Select the types)of fifes from the list above by checking <br /> the appropriate box(ez). At least one file type MUST be selected. Faz to /209)4GA-Di3b or mall to the <br /> addres3lndlCpted aboyg <br /> A. 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 flies <br /> will he held for a maximum of five bustness.days for revlew. Appointments.should be scheduled <br /> accordingly. <br /> 3. - A file that is actively being worked on by EHD staff may not be immediately available for review. A new <br /> application may be submitted when the file is avallabie. <br /> 4. Any Aix not retumad in the same condition as released WII1 be reorganized by EHD staff at the expense <br /> of the appilcant. Future file reviews by the same applicant may require a$87.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates mUSt be confirmed with EHD staff, <br /> 5. Applications recatV" after 3:DO pm will be processed the next business day. <br /> i <br /> CONFIRMED APPOINTMENT DATE TIME <br /> i DATF CONFIRMED PHONE FAX iNI'TIALs J <br /> i <br />