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07-14-2EG3 10;2'10`1 F TC i925263612: P.el <br /> 1:tti�FT[GLTIEJ <br /> SAN JOAQUIlN COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 3U4 FAST T WtZER AVENUE, THIRD FLOOR <br /> STOCKTON CA 95202 <br /> (209)488.3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> 'A1PPLJGAXTa _ GUSINP-SSIAG M11GYctr <br /> I <br /> r <br /> AiJfJREsB <br /> P)iQNE - 2 2-1 <br /> TENTATIVE-APPowymsldT DA'Z'E _ TIS <br /> '. (Please give 7 to 10 huSitKss days from daW of appliostlan,babrnittW) <br /> GNECK BOY TO EXPLEXTL REQ UF 0 ST r'Ft a IN?aU9)HEU DAYS <br /> SIGNATURE: OF APPLICANT DATE <br /> FILE ABD1LC�t3 TM SJDF&ID S AFP uSl:ONt.Y <br /> I . PREP-VA rp, nR&EA <br /> 1• S_ - > <br /> I • <br /> ! 'ENWRONMENTAL HEALTH DIVISION FILES <br /> UNDER040UND TANK(UST)CLEANUP 51TE(LOP) ❑ HOUSING ABATEMENT X1101-11)WASlT FACILITY <br /> OTHEK GL€AMJP SITE(NON-LOP) O FOOD FACiUTY O SOLW WASTE VEHICLE <br /> UNDERUROUND TARK(M0NIT0RUNG1RFiMGVAE1 0 DOG PU_z 1 R- ❑ DAIRY <br /> HAZARDOUS WASTE GENCRATCwt 0 CI-Or-KEN RANCH ❑ PKCA TRE,ATMF-NT PLANT <br /> q TILRFDF PERMni-ED FACILITY 0 MQTt limonl- 17 PUMPER T1WCKJYARD("EM TOL LETS <br /> E3 TAXI`0 18 Y PEJRCENG tn POOuePA t7 LAND USE APPLXATION SATES <br /> G} MEDICAL WASTE FACA iTY. U PUBLIC WATeR SYSTEM ❑ OTHER01EASE SPECIFY ABOVE) <br /> 7: LfrA up to ten adM-as"I in the space above, Select the type(9) of files from the tilt above by cFsecldny <br /> tric appropriate box(es)_ At Iea*t one 1110 typo MUST"be selected. Fox to (2Q2 9M-G-t 8 4r ma]I to the <br /> f addro indle-ated above. <br /> 2j EHD will notify the applicant if any EHD filer ex1SL An appointmantforreview will be confirmed <br /> approxlrTlatUfyfive business days but:no later than ten(10)days after racelpt of application. The flies <br /> will be held for a maximum of five bUsJneas days for rev)ew. .Appointments should be scheduled <br /> accordingly. <br /> �.' A file that is-actively being Worked on by EHb staff'may not be immediately avallable for revi*w. A now <br /> application may be sulOrnitted when lho file is available. <br /> 4,1 Any file not returned in.the same condition ac rgWased will be reorganaod by EHD.gaff at the expwme <br /> of the applicant" Future file reviews by the same applicant may t®Mulyd a MOD depozlt prior HO review. <br /> S."' 'TENTATIVE appointrnerlt dates must be eonflrm" whit EHD staff_ <br /> 6.s Appik,'attorls recalved after 3:00 pm will be processed the next buslnasa day_ <br /> CONFIRMED APPOINTMENT DATE TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> er ao 14 42r24" <br /> TOTAL P.01 <br />