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\\i <br />O <br />UliL kti ."tl'JC� <br />SAN JQAQUIN COUNTYPi 5LIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />a04 EAST WEE3ER AVE;NIJEw THIRD FLOOR <br />STOCKTON GA 95202 <br />{209) 4158-2420 <br />PUBLIC RECORM RELEASE APPLICATION <br />s-.IstNZSSIAQENCY, 4�"' <br />AD. R5S5 _� <br />ErW U'l <br />11-1 / MT11y 1 G"G" r_—:2 £4u r -a (� - <br />PHONE �3t�-!Y� <br />TENTATIVE* APvcoirrMUiTPATE <br />(PI•�a« give 7 to IQ t;Rainsss nays trom 4�atc pt application JWFJrndW) <br />Q CXF--K BOX TO EXPEM-i E RE"ES T a.e E - "sT PFOCP-5ZW tN Ess DAYS <br />SIGNATURE OF APPLICANT' DAT E <br />V/ <br />0 <br />E.'�iCtRCNMEhlTAi Hi_I,L7H nlYl$IOIV FILES A t (j ����� � <br />�' U���Gr20UtiD7Ab1KiU.g:} <br />CLEAt3tJP s1t E (tOF1 ❑ NOUSuiG ACATEMENT SOLID WASTE F G 2O lJ <br />c,6Tli R C CANUP 5117E 940N-LoP► ❑ FOOD FACILE Y G SOUP WASTE VEHICLE <br />UN4TDzR4KQWND TANK jMC)NiIQR1NCjRVhiQYAL) C DOG KENNEL 7 DAIRY <br />i-PZAnQ'J5YiA3TL GE)iERATOR d CHKn?4 RANCH O r= TRCATil CNTPLANT <br />7iERE1) PEPJAJT'!n FACJLM a M47EL.11<rrF.L ❑ PtjM?ER TRVCKJYARDlGRM rC4ZT4 <br />C 7A7fDCva'sObY VWCNrj O ROWSPA C LAND VSE APPUCATION SITES <br />^. ?41 I CAL YYAStE FACi:1TY d plj"n `NAT6R SYSTEM 0 OTHER (DLEAtE SPECIFY ADOVF-) MAY 31 2000 <br />1. i.iGt up to ten addreoacs in the S;5ace above. Select the types) of fifes fmm tyre list shove by checking <br />the appropriate boX(eb). At Toast one file typo MUST be selected- Fax to i222) A r &138 or_mail to the <br />;adtlres� ind;Gake�ai�ve. <br />2. Ei-[D wid notify the appiicurlt if any EHO files exist. An appointment for review will De cora rmod <br />apprtwdmately rive uusinoss days but no later than ten (i C) days after recelpt of appiicatiom The files <br />will be held for a maximum of five business days for review. Appointments should be scheduled <br />accordingly. <br />3. A file that Is activaly being wonted gn by F -HZ) 4taff may not be immadiatcly tlr"able for review. A new <br />app:icatiOn miay be 3ubinitted when the file is avaitable. <br />A. Aly fila not rot--urned in the same condition as released will be reorganized by ENO staff at the expitnse <br />of the applicant. Future Roe reviews by the came applic" may require a $78.40 deposit prior to review. <br />5. *TENTATIVE apgoirl,"t'Istlt dates must be cord-jrrned with EMD staff. <br />9. Appllcatinns recolved atter 3;00 pm will be processed the next business day. <br />CONFIRMED APPOINTMENT CJATE � TIME <br />DATE CONFIRMED � PHONE FAX II.71ALS <br />REVIEWED YES NO REVIEW DATE,. <br />as TOTAL F. 01 <br />d WdET :EO OOOE EZ 'hEW 2:886 8E8 60� LhJ dNOHd S [Sh j E� FI o�aZ punoa8 -. blOO_� <br />.. <br />�f / •.�LJ.� •�YfYI.��` <br />P.MI`G <br />4�i�.Y <br />%Ws <br />,�r�� <br />`� �� �7 1, � "tel• <br />r a • � • <br />� <br />V/ <br />0 <br />E.'�iCtRCNMEhlTAi Hi_I,L7H nlYl$IOIV FILES A t (j ����� � <br />�' U���Gr20UtiD7Ab1KiU.g:} <br />CLEAt3tJP s1t E (tOF1 ❑ NOUSuiG ACATEMENT SOLID WASTE F G 2O lJ <br />c,6Tli R C CANUP 5117E 940N-LoP► ❑ FOOD FACILE Y G SOUP WASTE VEHICLE <br />UN4TDzR4KQWND TANK jMC)NiIQR1NCjRVhiQYAL) C DOG KENNEL 7 DAIRY <br />i-PZAnQ'J5YiA3TL GE)iERATOR d CHKn?4 RANCH O r= TRCATil CNTPLANT <br />7iERE1) PEPJAJT'!n FACJLM a M47EL.11<rrF.L ❑ PtjM?ER TRVCKJYARDlGRM rC4ZT4 <br />C 7A7fDCva'sObY VWCNrj O ROWSPA C LAND VSE APPUCATION SITES <br />^. ?41 I CAL YYAStE FACi:1TY d plj"n `NAT6R SYSTEM 0 OTHER (DLEAtE SPECIFY ADOVF-) MAY 31 2000 <br />1. i.iGt up to ten addreoacs in the S;5ace above. Select the types) of fifes fmm tyre list shove by checking <br />the appropriate boX(eb). At Toast one file typo MUST be selected- Fax to i222) A r &138 or_mail to the <br />;adtlres� ind;Gake�ai�ve. <br />2. Ei-[D wid notify the appiicurlt if any EHO files exist. An appointment for review will De cora rmod <br />apprtwdmately rive uusinoss days but no later than ten (i C) days after recelpt of appiicatiom The files <br />will be held for a maximum of five business days for review. Appointments should be scheduled <br />accordingly. <br />3. A file that Is activaly being wonted gn by F -HZ) 4taff may not be immadiatcly tlr"able for review. A new <br />app:icatiOn miay be 3ubinitted when the file is avaitable. <br />A. Aly fila not rot--urned in the same condition as released will be reorganized by ENO staff at the expitnse <br />of the applicant. Future Roe reviews by the came applic" may require a $78.40 deposit prior to review. <br />5. *TENTATIVE apgoirl,"t'Istlt dates must be cord-jrrned with EMD staff. <br />9. Appllcatinns recolved atter 3;00 pm will be processed the next business day. <br />CONFIRMED APPOINTMENT CJATE � TIME <br />DATE CONFIRMED � PHONE FAX II.71ALS <br />REVIEWED YES NO REVIEW DATE,. <br />as TOTAL F. 01 <br />d WdET :EO OOOE EZ 'hEW 2:886 8E8 60� LhJ dNOHd S [Sh j E� FI o�aZ punoa8 -. blOO_� <br />