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cuuc uo:UQdM0 uKU 15103579053 T-730 P.00UM F-T99 <br /> \ + tHIiLIVI/V L.UUN 1 TVUtSUU HF-AL)H SEiJVICES <br /> V WIRONNIENTAL HEALTH I)MSIOf, <br /> �- i 04 EAST WEBER AVENUE,THIRD FLO 3R Q <br /> 'f STOCKTON CA 9520; / <br /> (209)408-3420 <br /> 02 J!N 11� r,'I : Z2 PURL W RECORDS RELEASE APP��Lrr.ICAMNl <br /> �{'��Fa?✓qpy'r LOe » BUSINESSIAGENCY <br /> �ja1tJDRP,Sa 2O 9 err,r_'=-�. c <br /> PHONE (_ -7a� c778• > °i-r..__^_,_PACSIkILE <br /> TENTATIVE,APPOINTMEI.TI1V /� / <br /> TIM _ <br /> tPlrx 0 IrwJJr 7 to to tlr4Lw,lss hem dale i wao <br /> CHECK BOX TO EXPEDITE REOM r )7$4 ea ST PRD/ssF9j�y�liSB GAYS <br /> / SIGNATURE OF APPLICANT r a ;LLa 7 > �(� �J DATE ��/S—�o�.• <br /> �-BILE A00i Eq i. THIS MOEEHO STA USL'OHL O <br /> Pito GRAM ELEMENTS SEARCH A' <br /> W <br /> IT U <br /> ? 0 <br /> I.NViRONMENTAL HEALTH DIVISION Flt FS <br /> "P/,lINDERGRWNO TANK(UST)CLEW,i Vn+(L.OP) D HOUSING ABATEMENT ❑ SOLIDwASTE FACIW7Y <br /> D PTHERCLEAWWSFTV-"JJM 0 FOOD VACUITY ❑ SOLIO WASTE VEHICLE <br /> 73�UNDERGROUND TANK CMONITORWa REIItrVAtt ❑ DOC KENNF<L. O DAIRY <br /> 13 HAZARDOUS WASTE OEUMTOR O CHICHF RANCH A PKGTREATMENT PLANT <br /> - <br /> 0 TWITED PERTAITTFD FACILITY n MOTEL/HOTEL ❑ PUMPER TRUCKNAMCHPN TOILETS <br /> TATTOO]HODY PURCING ❑ POOLI9PA O LAND USE APPLICATION SITES <br /> D W fINCAL WASTE FACILITY o PLIDLIC WATER SYST U Cl OTHLa(PLEASE SPECIFY ABOVE <br /> 1. List up to ten addressee In tt,e spate above. Select the type(s)of files from this list above by checking <br /> the appropriate box(es). PI least one fife type MUST be selected. FaX to 1200)404-013$of Moll to the <br /> address Ir dtcated above:_ <br /> 2 HND will notify the appll=Q H any PHI)files exist. An appointmel it for review will be confirmed <br /> approximately free bush lei,s days but no later than tan(10)days after receipt of appllc2tinn. The files <br /> will behold for a maxim in-of five business days for review. Appi,intrnenta should be scheduled <br /> accordingly_ <br /> 3. A file that is actively bel.T9 uerked on by EHD staff may riot be im1 nediately available for review- A naw <br /> applicmtlon may be subs ail I e 3 when the file is available. <br /> 4. Any file not returned in :ha a Pima condition as released will be reoe9anized by E H 0 Staff at the expense <br /> of the appiicanL Future fill stivlews by the same applicant may require a$89.00 deposit prior to review. <br /> S. `TENTATIVE appoIntrne.tt da tes must be confirmed with EHD staff. <br /> 8. <br /> App IIca tions received ager 3:00 pm will be processed the next bwAmoss day. <br /> CONFIRMED APPOINTMENT t Al'c TIME <br /> DATE CpgFIRMEn _- �._ PHONE FAX INITIALS _ <br /> REVIEWED YES NO REVIEW DATE <br />