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JUN-01-2000 15:24 6100DWARD-CLYEE CONSULTANT 510 874 3262 P.02i02 <br /> OFALV LAIUIN liV4lV 1 irunI-tt, nc;nLin Rvit c;Q <br /> WEANVIRONMENTAL HEALTH DIVIS� <br /> 304 EAST WEBER AVENUE,THIRO FLOOR 15 zz <br /> STOCKTON CA 9$202 <br /> i (209) 468-9420 <br /> PUBLIC RECORDS RELEASE APPLICATION _ <br /> III <br /> WPPLICAYT , �C-J[ a SINFSSIAGENCY <br /> 1. <br /> DORESS <br /> HONE l 1 I - D FACSIMILE 010— c6 �3.f-•t�- <br /> • Ili TENTATIVE'APPOINTMENT DATE 06 kodoc TIME IO:3O t <br /> (Please give 7 to 10 b in s drys from date or aFFllcatlm,Sdbmittal) <br /> I <br /> NECK BOX TO EXPEDITE REQUE, 8.00 FEE-REQUEST PROCESSED IN 3 BU=ESS DAYS <br /> SIGNATURE OF APPLICANT DATE OS a• <br /> i <br /> I <br /> FILE ADDRESS THIS SIDE END STAFF USE ONLY <br /> T(QE PROGRAM ELEMENTS SEARCH <br /> Sc tea N 713 E• LI t+kf..7[�fL uJAK �. <br /> SAW <br /> • Is 6 IN 14 • CN•.+•R•7�jL Lr1E1• f <br /> A 'aa AwAsr Atar P0,q 7 3- Wils+u WkY I. <br /> r4 /15A S, �45ontA434 2• > <br /> µAtiiia t+5 r F' !.2 5• ij o nl A- <br /> iJE nwr 5 • Slee AA VevAa4 3. <br /> t TN(a o 14.1(CSoN )• <br /> I 06Lz-.11 88-1 . S, tL9oN Al f• <br /> ��' eRV6 452.. 5• (.I,i4]epS GJ 1• I <br /> TA{ NE4 C45 . Isar C-l.+A-R.,ElQ- <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> f-'l)8. UNDERG ROUND TANK IVSri CLEANUP 51TE(LOP) ❑ HOUSINGABATEMENT ❑ S OLID WASTE FACILITY <br /> .�• � OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> 3•:R URDERGROUNDTANK(..yoNrrOR1NGrREMOVALI t7 DOGKENNCL 0 DAIRY <br /> 0 HAZARDOUS VIASTF rFNERATOp O CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> I❑ TIERED iERWnT?n rA JIU rY ❑ MOTELfHOTEL ❑ PUMPER TFUCKIYARDfCHEM TOILETS <br /> 'G T.1T i':Qi Ot•Y r_RCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> 1C1 .5.7 E. ILITY ❑ PUBLIG WATER SYSTEM t] OTHER(pIEASESPECIFY ABOVE) <br /> I 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 one file type MUST be Selected. Fax to (209)464-0138 or mail to the <br /> j address indicated above. <br /> i2. FHD will notify the applicant if any PHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten(1 D)days aftar receipt of application.'The files <br /> will be held for a maximum Of five business days forreview. Appointments should be scheduled <br /> accordingly- <br /> 3. A file that is actively being worked on by EHD staff may not he immediately available for review- A new <br /> application may be submitted when the file )s available. <br /> i 4. Any file not returned in the same condition as rolleased wilt be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a S78.00 deposit prior to review. <br /> 15. 'TENTATIVE appointment dates must be confirmed with EHD staff, <br /> 6. Applications received after 3;00 pm will be processed the next business day. <br /> !i <br /> t CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRM ED PHONE FAX INITIALS <br /> REVIEWED YF . NO NO REVIEW GATE - <br /> EN w 1< <br /> . TOTPL P.01 <br /> J6 TOTAL P.02 <br /> A � <br />