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TO MW M' S55 P-01 <br /> FU <br /> Eli!i..V�i N{ G�H <br /> JUL 2 X000 SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> ENVIRONMeNTAL HEALTH DIVISION C� <br /> ENVtRONMEN� HEALTH 304 EAST VVEBER AVENUE,THIM IFLOOR <br /> STOCKTON CA 95202 <br /> l pERMISMSERVICES (209)488-3420 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPUCANT rr ,,i , .7 f f� ssr�8 >�,7cY� <br /> ADDRESS li/U1 U����tt hh��l Y ��L tFi <br /> PHONE <br /> TENTATINS'APPOINTMEKI'12ATE TIME <br /> Wiemse Sive 7 to l O bdtin*=days trate date of apprieoLion subrnMall i <br /> C14FCK gpX'o WapMTE REQUEST_S?'IL4D FI:E—REQUEST PROCESSED LN 3 5USuvESS DAYS <br /> j sIGNATtsn OF APPLICANT � 0ATEQ9jaA M <br /> T IFV'SIDE BKO STAUBF ONLY <br /> >=iLE ADIIitE&S <br /> i PROGRAM ELEMENTS SEARCH <br /> C-1 - <br /> M <br /> w-z <br /> 06$ C <br /> i <br /> f <br /> eXV R,OiqMENTAL MFALTH DIVISION FILES <br /> UNDERGFLGUND TANK(}.IST)CLEMUP SITE ILS 0 HOWINQ ADATUMEtW 0 40LIP WASTE FACILITY <br /> C OTitE9 CLEANUP 5TCE(NOK-l..M 0 FOOD FACILITY o SOLID WA=V!"IC1E <br /> 0 L1N DSRGROUND TANK(MOKI'TOlilUGntEMOVAL) IS DOC KENNEL 0 DAIRY <br /> RAZARDOUs VvM M OF_NEP.A'r0R 0 CI rXEN RANCH M p"TREATMENT PLANT <br /> [7 77ERED PERlefrl'1=0 FACILITY Q MCr 7ELMOTEL E) PUMPER TRUCIVYARDMNEU TOILET# <br />{ 0 TATTOGrOODY PEf>ING Q POOLMPA 0 LAND LZE APPLMATION Sr= <br /> O ME131CAL WASTE FACiUrr l ID Pi suc WATER SYSTEM C3 pnLEa tPMA&E WV_CIFY ABOVE) <br /> 1. List up to ton addresses In the space above. Select the type[S) or file$from Cho rmt above by checking <br /> the appropriate bug*&). At least one file type MUST be selected- Fax to 12091464-0138 or mal fa th <br /> ift <br /> 2. EjJ0 will nobly the appilcant If aGY EHD files exert An appointment for review wilt be cantrmad <br /> approximately firs bUslAeSS days but no later tti2n ten(10)days after receipt of 4pp110at1QnL The Elias <br /> will be held for a ma7CilrlUM of five business clays for review. Appointments should be srbesduled <br /> accordingly. <br /> $ A file that is actively being worked on by EHD sUV may not be immediately available for review. A new <br /> application may be submimad when the file is availab4a.i _4r <br /> Any file not returned In the same condition as releasW will b y�rgani a$79.0 E tlspUIT Rt th to a Griew. . <br /> of the applicant. Future file reviews by the same appltra <br /> ek w'rENTAT[Vt appoinbwml date must be Gonfirt6ed With EM staff j <br /> 6 AppliratIOAS received after 3:00 pm wW be proce"ad the nwa bus1ness day. <br /> CONFIRMED APPOWTMENT DATE TIME <br /> IDATE coNFIs MI) :,., ,._., PRONE FAX INITIALS <br /> REl/lE1NP❑ YES NO REVIEW DATE <br /> Cy o0 <br /> � trsr34_ la.eii <br />