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SAN JUIN COUNTYPUBLIC HEALTH S#%a4ICES <br /> ENVIRONMENTAL HF-AL-TH DIVISION <br /> 304 EAST WESER AVENUE'THIRD FWOR <br /> t(/ STOCKTON DA 85=2 <br /> (709)46&3420 <br /> PUBLIC RECORDS RELEASE ApPLWA ION <br /> APPUGANT '� " —.✓iC/��l7 eusIN�9SJADEaIGY <br /> C� FACSINLE <br /> TENTATIVE"Af'PanKT1AET DATE TIME <br /> (P1,03a give'lir to i bvemm-a daydate of 8op11oM)6f1 suCimillal) <br /> u�vlfis 7;'25 , <br /> ED cNECaC Box TD exPe.DiTE RECtUZST-$78.00 FEE-REQUEST PRCCES2ED 3 BUSINESS DAYS <br /> DATE <br /> SIGNATURE OF APPLIGANT <br /> FILE ADDS.. <br /> .S <br /> Q _- . 62 dOZ? <br /> S <br /> Age er) <br /> G <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> liNOGAGROLMAP TANK(UST)CLIIANUP SFM(LOP] D HOUSING ABA MM*NT SOLID wA,STE FACZJTV <br /> GIJEpWgP TRE(040"C" a FOOD FAcaJVY SOLID wASTS VOWME <br /> UNQERGRdMD TANK QAOMTOiZlirOMEMOVAL) O DOG IENM L O DAIRY <br /> t1AtJti�DOUS MI/18sE 661�W 1T�QR 0 CHICKEN RANCH PKG TIZFATMENT PIANT <br /> I7 T1EREd> ,n-raQ FAORJiY ❑ J1oT"OTEL PUYPF2t TRt/CiilYAt�IC>i TOR.67 S <br /> CJ TATITXeWM p1E1f FAC 0 POOLMPA USE APPLICATM SITES <br /> bAEpICAL Vmsm FACRJTY ❑ PUBUG WATER SYSTEki HE <br /> OTyR{�PLEAS6 SPECIFY AEIOI►E1 <br /> 1. List up is tan addresses in the space above. Select the type(=)of files <br /> t�tx�o914 164-0935 0� 11 oeddng <br /> the appropriate bogs). At least one file type MUST be selected. <br /> Famxagd=§tndlg9W above. • <br /> 2. Elie w ll notify the applicant It any EHV flies exist. An appointment for Ce review will be cnron. Th <br /> approximately five buskuns days but no later than ten('10)days after rec=eipt of application. The files <br /> will be held for a m=aximum of fire business days for review. Appointments should be scheduled <br /> m=a <br /> accordingly. <br /> 3_ A file that is actively being worked on by EHD staff may not be immediately available for review. A now <br /> application may be submitted when the file is available. <br /> 4. Any fit*not returned In the same condition as released will ba unorganized by EHD staff at the expense <br /> of the applicant. Future file reVI*Ws,by the same applicant may require a$78.00 deposit prior to review. <br /> S. `TENTATIVE appointment dates must be oonfinned with EHD staff. <br /> 6. Applications received after 3.00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME j <br /> I <br /> DATE CONFIRMED PHONE FAX INiIZAL.S <br /> REVIEWED YES NO REVIEW DATE <br /> am a M • <br /> TOTAL P.02 <br />