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b^Ta RC40VEO V .�11 WC.MUi16Eit <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES V } <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE.THIRD FLOOR <br /> STOCKTON CA 95202 ��K �7 ���� <br /> (209)488.3.420 <br /> -- PUBLIC RECORDS RELEASE APPLICATIQ ,� . E,,,;:,,tom <br /> APPUCAN .. ;�1it//. C' /rr susti��sSIAGEticr G <br /> ADDRESS <br /> .FACSIMIUL <br /> TENTATIVE-APPOINTMENT DAIS 'MF — -- <br /> (Ptease give 7 to IG bcrslnoca days Gam date Ot app64adem suomiitatl <br /> ID CHECK FEE-REQIJFST PfCOG!" AM Iii 3 OUSINF-SS t)AYS <br /> SIGNATURE OF APPLICA BATE <br /> FF AnnaFq¢ <br /> Him . � <br /> _ .0 <br /> X� <br /> X11 r pe <br /> 3S -1k t4k— <br /> .c. <br /> ENVIRONMENTAL HEALTH DIVISION FILE$ <br /> jk7NDCtWRPUND TANK(UST)CLIE-ANUP SrTE(LOP) ❑ HOUSING ABATEMENT �SDLJU WASTE FACILITY <br /> ? OTHER CLEAKUP SATE(MON-LOP) M FOOD FACILiT1` fi 0 SOLID WAS f1:VEHICLE <br /> g NDERGRM)ND TANK(NONITOFt1[aWRErrMOVAL) y Dor.KENNEL 0 DAIRY <br /> ` +mAZAAp*Us WASTZ GENERATOR M CHIGKEN RANCH D PKG TREATMENT PL MT, <br /> L7 TLEREQ PERMITTED FACILITY ❑ -MOTELMDTEt. 0 PUAApER TRUGKIYARa1CHE TOItETB <br /> © -rATTO000f)T PORCING E3 POOLtSPA 0 LAND USE APPLICATION S11ES <br /> 0 MEDICAL-WAS'T'E FACILITY b PUIBLIC WAVER SYSTEM E3 OTHER 115E SPE7CIFY ABOVE) <br /> 1. List up to ten addresses in tho space abova. Select the type(s)of files frorn the list above by chegking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(2Q9?4 4-0138 nr r�aii to the, <br /> addEtIL.1%Indic ted allay <br /> 2. EHD will notify the applicant if any EHD files exist An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10)days after receipt Of application. The flies <br /> will be hell for a maximurn of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be Immediately available fpr review- A new <br /> application may be submitted when thQ file is available. <br /> 4. Any file not returned in the same condition as released will be reergartized by EMD staff at the expense <br /> of the applicant. Future fife reviews by the same appli amt may require a$78.00 deposit prior to review- <br /> 5. "TENTATIVE appointment elates must be confirmed with END staff. 4 <br /> 6. Applications received after 3:00 pm will be processed the next busineso day, <br /> CONFIRMED APPOINTMENT DATE - TIME <br /> DATE CONFIRMED PHONE FAX INITIALS <br /> REVIEWED YES NO REVIEW DATE <br /> TOTAL P.02 <br />