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01/$1/21103 .13:28 II •.464013 EWIRD*ENTAL Int PAGE 01 <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> F 9 0 6 Z 103 y ENVIRONMENTAL HEALTH DIVISION <br /> 394 EAST WEBER AVENUE,THIRD FLOOit ' <br /> STOCKTON CA 95202 <br /> (209)450.3420 I� <br /> ��--�, • PUBLIC RECORDS RELEASE APPLICATION <br /> APPLIC ssZa K�o9 nom¢ 1 <br /> I ,.BUStNEss)AGENCY. -` W S <br /> ADDws �7 Y�Amre 12oD a G <br /> aNONe !CoIU- 33 7 FAcsiRLE__ GI o _ 33.1 2-149 _ <br /> "�� k <br /> TENTATIVE*APPOINTMENT OATTIME <br /> E 13�b3 <br /> (alease otvo r w t o bwt sa daya from wife of Fppilron aub*ultal) 1 ^ d l <br /> (� •• fiw-� o ie..,. '.(++-k ak t <br /> CHECK BOX TO EJOPEDI7E REQUEST•;89A8 FEE-REQUEESnT PROCESSED IN J BUSINESS DAYS .r1 <br /> *StGNAI)tIREOFAPPLICANT/rXGG //^e Q <br /> DATE <br /> 'T fiLE ADDRESS 11115 SIDE END STAFF USE ONLY <br /> I` PROGRAM ELEMENTS 59MOR <br /> t <br /> �t S <br /> ll . <br /> * z t Y e <br /> O C1 her 7- - <br /> i <br /> t ' <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> i <br /> UND RGIA0*3 TANI((UST)CLEANUP SITE(LOP) O HOUSING ABATEMENT O SOLO WASTE FAgLrTY . <br /> O OYNE CLEANUP 3n1:(NON4,OP) O FOOD FACILITY O SOLD WASTE VEHICLE <br /> JIX UNDERGROUND YANK(NONiTORINGIREMOVAI,) O COG KENNEL O DAtRT <br /> - Ar NAZ onus wAsTe GENERATOR O CWCKEk RANCH C PKG TREATMENT PLANT i <br /> C. TMIC41)PERMITTED FACILITY t7 NOTEtA10TEL CT PUMPER TRUCKIYARDICNEM YOI)M <br /> o TAT140IBOOY PMCe1G O POOUSPA 0 LAND USE APPLICATION SITES <br /> I. 4 MEDT WASTE FACILITY i C OYKER(PLEAsE SPECIFY ABOVE) �I <br /> 1. List up to ton addresses In the space above. Select the typo(s) of fles from the list above by checking <br /> the appropriate box(es). At least one Gla typo MUST be selected. Fax to(20.9)464-0138 or mail to the <br /> address indicated above. <br /> 2. EHD will notify the applicant if any EHD riles exist- An appointment for review will be confirmed <br /> approximately Ave business days but no later than torr(10)days after receipt of application. The riles <br /> will be hold for a maximum of five business d#ys for review, Appointments should be scheduled <br /> accordingly- <br /> 3. <br /> ccordinOty-3• A file that J5 actively being worked on by EMD,staff may not be Immediately available for review. A new If <br /> appl(wpon may be.subntitted when the file is available. <br /> 4. Any file not ret(frrled in the same conditioe as-releasod will be reorganized by EHD staff at the expense E <br /> of the applicant. Future rile reviews by the same applicant may require a$09.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> G, Applications received atter 3:00 pm will be prgcessed the next business day. ? <br /> Po6t-1C Fax Note 7671 D-1s0 0 Iwy„�► f <br /> CONFIRMED APPAINTMENT DATE, TaFrom 1 <br /> CGJDCL Ca - <br /> DATE ONFif{MED . e a I <br /> LREVIEy1ED YES NO <br /> Z00/Z0o'd T961# UNIZED SN❑ 6VTZL££O19 0:91 EOOZ,90'931 <br />