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�V <br /> S CAQ iR C"L"'T PUBLIC HEALTFf6Ii;ViCES '"0L«nwoc <br /> EhViRONMENTAL HEALTH DIVISION <br /> 304 F.45T WEER AVENUE,THIRD FLOOR <br /> STOCKTON CA 75202 <br /> (249)46a-342b <br /> PUBLIC RECORDS RELEASE APP <br /> :ANT I - F !� �� UCAT)O <br /> ,VSs Zz t—� BUSNE33AaERGT I�Pa_I O v 4 y g �S-Oc <br /> .:ONE u/"1� .�(p�• _ .z-;}y�l„�_PAC3137tiE <br /> TERT�ATPilE*APPCll JRT.VEmENT PAT: <br /> (ptaom vive 7 to SQ Qvtlp�y,6a s rtdn nuE <br /> }r�---- T sato a�pptk U..�uOmfliflj <br /> U CHECK sox 7D ExpP�trL•R.rO.t� T.STaQQ F•�_REQUEST VROCESSF.D 1t73 EU3Wa�S DAYS SIGNATURE pF AP I L TA, �/� ./l, <br /> DATE <br /> FILE ACOR 'M <br /> Y CD pzo <br /> O y Y 2 lf,i` �. <br /> 2 r <br /> C rp <br /> 51 <br /> JU” <br /> V o vcr <br /> ENVIRONMENTAL HEALTH WVLSION FILES <br /> MUN3ERUROUND TAMK WS-T)CLEANUP UM(:CPJ ❑ 4=1,,M A7ATEMEftt' <br /> ❑ OTr(eR CLEAUUp SITE(Hw"CF) a P000 FApLtty `3OtJG WASTE FACILITY <br /> UNDER6RCWtD 7ANa(stDN1TOR1Y01R'tT:TOYAta II DOG xEtIt1FL Q D.�Y WASTE VFRnCLE <br /> A.HAZAR000a WA"G�RATDR C DH7LXENH11rRiff <br /> O TIM"t PRRm TTeD FACY.I.r Cr PKtl TRCA711ENT PtA.N7 <br /> MEMCA ODy WAST EtRc3L,, Q MOTE1.rTA 17 PtiWeRTRUDKf4AROtCHENTOaF{$ <br /> O 3tFAlCAIWA6YE FACILITY ❑ Pusuaw El LAND WE APPUCATIONStreS <br /> C above, <br /> Select <br /> ele t 6YSt7:74 ❑ �(PLEASE SPECIFY ADOvE) <br /> f file aLtp to fen aearossos in the space above. SeleC the types)of files from the U31 above by checking <br /> pproprWe box(es). At least one file type MUST be selected. Fax to f7D9) ,=. rrhaif to fh <br /> aadTass In 1kotrd aboyp, <br /> 2• EMD wltl notify dl*app1Cani N any END fges exfat An <br /> aPPfoximately fwc business days but no later than ten Od aye aftfor <br /> r rj �a!gt be confirmed 1 <br /> will be hold for a maximum of five"34wss day$fa review, ppOw6on. The UAs <br /> accordingly. Appointment$should be scheduled <br /> 3. A file that Is actively being worked on by E40 staff may not be Lmmadlately avallable review. Anew <br /> for <br /> Q aPAlloatian MMY be submitted when the fila is available. <br /> Any fife not returned in the Same condition as relaa�will be reorganlltart by EHD staff at the expense <br /> 5• <br /> of the applicant Future file reviews by tate same applicam may require a$78.00 deposit priorto review, <br /> TENTATIVE 31*01 ttrnent dats5 trust be confirmed with EMD Staff. <br /> Applications received after 3.07 p,Tl will be processed We neat business flay. <br /> CONFIRMED APPOINTME.47 GATE 71ME E{ <br /> I OAT'):CONFIRMED PHONEI f <br /> FAX fNITfALS ) <br /> REVIEWED <br /> aH w . waaw YES No REVIEW DATE <br /> TDTrL P.01 <br />