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�" � - t_�5 � � S' t� � ^r, t`he -. k�wR } i! vN r �# x �^� s�.v,»a W-�u w.'- y r `���"++ rB.."f q �t «,»+ t ✓ <br /> a.1,w4N • . <br /> �w tae�ocn <br /> ;�" ''ll- t F SAN JOAQUIN COUNTYPUBL1C HEALTH SERVICES � <br /> r : LSD v ENVIRONMENTAL.HEALTH DIVISION � <br /> :j .�� � <br /> 304 EAST WMER AVENUI,WPM FLOok <br /> SEP 2 12004 STOCKTON CA 95202 <br /> (W9)4684420 <br /> -­1ENVif°j'NhV1EN*1-HEALTH. PUBLIC RECORDS RELEASE APPLICATION <br /> APPUCAN1 1 eUSIt;WWA=CY <br /> Puente_pt7 2 3 —Lf 00 0 'PAS ' LE of 25 Z.93 C., <br /> TtwTA,TfVE"Appow wmEMr i>A'M <br /> (Plafte Qtvv T G 94 busloma*p tri►elute of appit+ dim svbmlu69 <br /> 13 Cll_CK DOXTOEXP'EDITE4uF„5T- .otl QUt"S P SM Pi D 8VSINESS DAYS ' a/v <br /> *SIGNATURE OF APl'(.iG MATE rJ"" <br /> E ADDRESS THIS OF DID STAR Re oWY <br /> VROGAAM EIMENIYS SEARCH <br /> 10 1 w es-t jit M, <br /> 33 •4-. u� � <br /> ENVikOMMENTAL HEALTH DIVISION FILM � <br /> • as <br /> WASTE <br /> LiNrlEliC*ROOl+tY1 WANK CLEAMVP 6ffE O tiOtiStltG AR1AT�fENT ya..SOt.O AStt; Qr� <br /> OTHER C"UP SITE"ON•Lt oC <br /> tINO>:RtiRA{t�t@ TAM(4AQI"fiTaR>r(G/REGAQd/ll,} F000 XMML OS F d 13AIRY. fit <br /> $ <br /> WgARMIOUS WASTE o TOR a CHICIMN RANCN 0 PKG*MEAYMENT PLVa <br /> TIERED P15Rwth'I•EG F O MOTMAHt�I• G 'tRUGK/Y M ftWrS VV <br /> TA'ITOMODY .0 POOUSPA D k Am Vss TfCMf EMS <br /> D McDMAL WAVE FACILITY : O OTHER(Pf MK OPeCM ABOVE) <br /> 1. Ust up to ton addresses In I"space above- Sela ct the type(s)of rites from the list above by checking <br /> the appropriate bax(est. At least ane file type MUST tm selected. Ea x to(2, M091464-0138 or mtiif.to-the <br /> addrrss indigted above. <br /> 2. EHI)will notify the applicant Ef any END figs e*L An appointment for rdview will be-contmi 0d <br /> approximately five businass days but no later than ton-(10)days after raceipt,of appf:cation. The tiles <br /> will be held for a maxi mym of five business days for review. Appointnlettts should be scheduled <br /> accordingly. <br /> 3. A file U=t Js actively bbing worked on by EMO staff may not be IMMOC112101y ftv4Inblts for review. A.nev <br /> applimatlort may be.submiUW when the filet Is avallable. <br /> 4. Any fire not rettirned in the Samq condition as releasod will bt'reorganized by E14D staff at the expernst <br /> of the appllcanL Future lite reviews by the same applicant may require ft$89.04 deposit.prior to revicv <br /> S. `tENT4*E appointment dates must be cofltlt'nled with EHD staff. <br /> 6. Applications rcnetvvd after 3:00 pm Vitt be pro=axad the riext business day. <br /> �- CONFIRMEQ APPOINTMENT DATE, TIME <br /> DATE CONFIRMED PHONE FAX INMALS <br /> IZ1rvlEVVi:D r YES NO RMEW DATE-* "' <br />