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,02 12:47 FAX UO2 <br /> X002 13:36 46 ENVIFj3NMFNT"-1-H PACE 02 <br /> !MO-I�MUMPlf <br /> \ SeN�n <br /> \v y QUIN LAMENT PUBLIC HEALTH S>=RV10E3 ®� <br /> 04 EAST <br /> ME ERA HEALTH D FLoON <br /> 3041=AST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 95202 <br /> (209)468.1420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> (� IPL��Itr �(, �ct 'CGfn�1LM(x,ls I I -11 /-d a��-�s/,AD�EwCr esea.�ch Se+�✓%ce-s �- -- — <br /> AODRE65 �'[ 31 L41 Kt �E LU�L�dS�CL4.CI4lI I�(7 �a2 Q6�,3 <br /> "CINE t��0y FAL�rMILE <br /> �15�aZ w?� <br /> TENTATIVE'.APPOINTMENT DATE 1 <br /> TIME <br /> (Plfafe give 7 N 1a b Wkgav off liat(an sLit' sl) i 1 <br /> YA r�`° <br /> 17 CHECK 60X70 EXPEDITS REQUEST- e.n FEE- OUCST PfiOCES D1 BUSINESSDAYS ^s 0A <br /> ,//�/, ie _ � G{,{, DAT£ v�o <br /> SIGNATURE OF APPLICANT' �/��� J; <br /> F USE NUT <br /> FII ADDRESS TRIS GIDE EHD HT AF� <br /> \ PROGRM -EtEE7+TS SEARCH <br /> 1 <br /> l <br /> ENVIRONMENTAL HEALTH DTVIt31ON FILES <br /> ❑ SODU WASTE PACY <br /> ILn' <br /> �IMERGROUND TANK Nsn CLEANUP SITE l�Pl O HOUSING ABATE-HENT❑ FOOD FACILITY O SOLID WASTE VEHICLE <br /> O-p171ER CLEANUP SITE(HONa-OP) 13 DAIRY <br /> 't NDERORDUNO TANK(MOMmDRfM7—'MOVAL) �G KENNEL ❑ PKO TREA71'IENT P6AHT <br /> .7we RnOUS WASTE GENERATOR ❑ CNICI�N RANCH ❑ Pumr R TRUCIVYARDiG>1EM TTJ11.Git' <br /> ❑ TIERED PPRM[l fEo FwCILRY r3 MOTP-1RVTrL C3LA14D USE MPL(CAT ION SITES <br /> TATi170lnoDYPEiRCYNG [3P <br /> C3 EITHER(PLE-A-SE SPECK'ABOVE) <br /> in MEDICAL WASTE FACILITY . ❑ PUBLICwATER SYSTEM C3L <br /> W <br /> i. Litt up to ten addresses in the spaei above. Select the types} of Tile-from 9l 4B4-D738 or m e list above by eh o�9 <br /> the appropriate bOx(e5}. At lust one file type MUST be Sytected. Fax Q <br /> dre LzjndicouNf a PP Y Appointment for ravicw will be confirmed <br /> 2- EHD WIII notify thea licant if an EHD files axial. An oP� Y p I,cat)en, The Tues <br /> approximately TNt business days but In laterss d t s f r rne(vl Appointments� pshnuld be scheduled <br /> will be hcld for a maximum of fie"*buslnGs days <br /> accordingly- being worked on staff may not be immedlately available for review- A neW <br /> 3. A file that is actively Flip sqq at the expanse <br /> application may be submitted when the file Is available- anfzed by <br /> q- Any file not returned in the same cenditlon as roleas9d Will mareorg tri a$89A0 deposit prior a Por'se. <br /> of the applicant Future file reviews by the acme app Y C <br /> 5 'TENTATIVE appointment dates must be corr"Frr ed with EHD stnff- <br /> g Appiicetlons.ecvwed after 3:Do pm will be processed the next business day. <br /> LDATE <br /> RMED APPOINTMENT DATE, <br /> TIME <br /> PHONE FAX INrrtAL5 <br /> ONFIRMED <br /> ED YES <br /> NO REVIEMi DATE <br />