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`� 1�-17-26HG3 10 2 14 FRI TO 1L5cj2YD1T712G P.02 <br /> SAN JOAQUIN COUNTYPUBLIC HEALTH SERVICES <br /> E=NVIRONMENTAL HEAL7N DIVISION I <br /> 304 FASEB <br /> T WEBER AVENUE,THIRD FLOOR �, <br /> STOCKTON CA 9502 �YY J <br /> (2D9)468-34201 <br /> , PUBLIC RECORDS RELEASE APPLICATION <br /> ,APPLICANT 1� �/�1 f 1 )e6%j-f_Q r 3 BUS14ES3IAGENCY � ( W l.L�✓l tl`�Gt-��fl�� i <br /> I <br /> ADDRESS5 7 (��vldhrc� S <br /> —7 <br /> PHONE 'a}f —FACSIMILE <br /> TENTATIVE`APPOINTMENT GATE ` ' 7lktre r / •' !Y7 . <br /> (Please gilder 7 to/�70�rbusi essrs( dam of appl{caGan svbaaiRai) <br /> L/1 / l <br /> CH5CK BOX TO EXPEDITE REQUEST-437.00 FEE--REQUEST P CESS COIN 3 BUSINESS DAYS <br /> SiGNATURi~4FAPP LlCAiVT ` I DA'T'E ��� <br /> A <br /> FI1,E ADDRESS T"IS$IPE EM STAFF RISE ONLY <br /> PROGIIAM ELEMENTS SEAMH <br /> ,c lYt7f�f'.raa�t L.d I'?e <br /> Ke&&- Lot.a ). leel, �'A 'a K <br /> 6 �- Kt 1FlC rrtav� L_a.n t. lid: �9Sa 3S� c- <br /> F-MVIROMMENTAL,HEALTH DIVISION FILES <br /> 76-UNDERGROUND TANK(UST)CLEANUP;SITE{LOP) © HOUSING ABATOnEitiT Q SOLID WASTE FP,GILnY <br /> C] OTHER CLEANUP SITE(NON44 1 0 FOOD FACILITY a SAUI)WASTE WHICLA <br /> [7 UNDERGROUND TANK(moNIr0RING1R6wtovAL) ❑ DOG KENHEL 13 DAIRY <br /> 0 HAZAPWQkJS waSr>"GENERATOR O CPOCKeN RANCH CI PKI&TREATMENT PLANT <br /> a TIERED PVIiTTED FACILITY it Ii TUMOTEL 0 PU PL�R7RUCK1YARa1CIiElYlT0ltl:TS <br /> C: TATTM500Y P$IRCtWG Ca POOLISPA - • 0 LAND USE APPUCAMN SM <br /> MEDICAL WASTE FACLITY C3 PUBLIC WATER 3 ISTF-iA 0 OTHER(PLEAS$SPACIFY ABOVE) <br /> 1. List up to ton addresses in the space above. Select the type(s)of files frorn line list above by Checking <br /> the appropriate box(es), At least one file type MUST t-e selected. Fax tnj"U)464-0138 or mail to the <br /> address Iridlsate_tl above. <br /> 2. EHD'wrill notify tho 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 atter receipt of application.-The riles <br /> will be held for a rmaxlmurn of five business days for rsviaw. Appointmanta should be sehedvied <br /> SGCordingly, <br /> 3. A file that is actively being worked an by 1-HO staff ally not be immediately available for review. A now <br /> appI104tion maybe submitted when the fila is aYailabi®. <br /> 4. Any file not returned in the same condition as reieast�l will be reorganized by ERD staff at the expense <br /> of the applicant. Futxtre file revlaws by the carne applicant may require a SHT.00 deposit prior to review. <br /> 5. "TENTATIVE appointment datee rrust he confirmad with Ef iD staff, <br /> 6. Applications radeived after 3:D0 pm Will be processed the creast business day_ <br /> G <br /> f,�ONFiRMED APPOINTMSNT DATE — TIME <br /> r <br /> 4ATE COMFIRMED -- PHONE FAX JNITIALS <br /> VIEWED YES NO REVIEW DATE I <br /> IM W 14 OW07MO <br /> { <br /> TOTAL. P-02 <br />