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SRN-21-03 10]41 RM � 0X0X0X0X0 <br /> 55^ 325 2297 P.01 <br /> 01.21/2003 BE:5"<t 4640138 EIi,IIF'pflldENTAL iN PAGE 01 <br /> SAN JOAQUIN COUNTYPUSLIC HEALTH SERVICES l <br /> ENVIRONMFNTAL-HEALTH DIVISION ^ +� <br /> 304 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 952.62 <br /> JAN 2 1 200J (209)468-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPtJ A}iTT�L Lr �� 'tA C'f S OUSINEESS-IAGENCY L 1 W�!� 1 • 'l <br /> ,{c I}ADO REJf$6 � 5� I_ CSVIG S 1Yt C 'I�` � j <br /> ,C 1`PHONIj ULA ��J S 1)Lr _F/1LIgAIMII `' r <br /> \\ TENTATIVE'APPOINTMENT UA1r. <br /> ;PlaaAa elYa T to in IIUTin01%evin from nate ar•PPticallan submittal) <br /> GtIEGh RRA TO FxPf nITF RFI110.5T. 00.001,//64 nCQULCr rtOOE0GE0111 D 130I11t SS pA'!S <br /> SIGNATURE OF APPLICANT 4` � � _ DATE ___ ay <br /> FIt.E AODRE66 THIS SIDE END STAF USB ONLY <br /> ----�--- ------ PROGNAM ELEMCNTS SEMCH <br /> ✓ $G1 QuuGLRSQUAQS <br /> 3. <br /> h6V✓D'Vl <br /> # V -75?5 ION <br /> a c. <br /> wr C(TIIERUD <br /> �aYt 5-tr ftp tl. 1,1 '7, { .',',4. U• <br /> 44 3;i r0kL 1 4 --c_)JJ{����jj11ONM�NTAL HEALTH DNISI N FILES <br /> DERGROUND YANK(VST)CLEANUP SITE(LOP)(LOP)''gbTtWOUSING ABATCMRNT 3 C] aOUD WASTE VEHICRZOUDWAS � <br /> HER CLCANVP SITE;NON-LOP) FOOD FACILITY � DAIRY <br /> . <br /> DERGROUND TANK(MONITORINCIREMOVALI tT DOG KENNfiL 0 <br /> YMDOUS WASTE GENERATOR O CHICK0 RANCH p� PKG TREATMENT PLANT <br /> pGRMITTGO FACR-rrY O MOTCUIIOTCL 0 PUMPtn TnUGHNAhOIOltrm YOt.LCTa <br /> C7 TATTOWdtlDY P[IRCING O POOIISPA O 6ANO u$t APPLICATION Srr9r ,;- <br /> O MeaICAL wnsTE FACILITY OTHER(PLEAS:5REGaY A90VE1 <br /> A sW t tT , <br /> 1- Ust up to ton addresses In the space above. Select the typo(s)of tilos from the Ital above by ch4eh4fj{l,_,_,. <br /> the appropriate box(es). At least One rile type MUST be selected. _FjL2to(2091 ,64-0198 or mtR to Ihv <br /> address Indicated abavc. <br /> 2. EHD will notify the applicant it any EHD files exist An appointment for roview will be confirmed <br /> approximately ays after rvcolpt of application.live buslnass days but no later than ton(10)dcation. Tho Ille(, <br /> will be held for a maximum of five business days for review. Appofntmonls should be scheduled <br /> accordingly. <br /> d <br /> 3. A file that Js_actively beinD,werkoon by EHD staff may not be immediately available for review, Art <br /> qy t <br /> applloatlon may bo submitted when the file is available. <br /> 4_ Any file not roturnod its the cams condition as folsaaad will bb rvorganired by EHD staff at the vnyarijd <br /> 31fs;- " <br /> of the applkant. Futuro Rle roviEws by lhu same applicant may require a$69.00 deposit prior to rovleW,.., <br /> 5, •TENTATIVe appointment dales must be confirmed with EHD staff, <br /> G. Appiicalions received after 3:00 pm will bo processed the noxi business day. <br /> —RU °i <br /> CONFIRMED APPOINTMENT DATE ___ <br /> 'TIME – <br /> DATF CONFIRMED _ _ . PHONE FAX INITIALS <br /> q <br /> REVIEWED YES N0�_ \ /J REVIEW DATE . <br />