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) T0 1`�SdG'?.�9 P.01 <br />I <br />�h M F* <br />v Cry 11V4 NWE+ri" . <br />JUL 2 6 2000 <br />SAN .�C7r QUIN CaUNTYPUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HATH DIVISION <br />ENVIRONMENT HEALTH304 FAST WEBER AVENUE, THIRD FLOOR <br />sTOGKTON CA 95202 <br />PERMIT/SERVICES <br />(209) 469,UM <br />PUBLIC RECORDS RELEASE APPLICATION <br />IAF r- <br />TENTATiYE' APPOMVIENT CAW TIME ---�- <br />(Pieage $ivt 7 tc y D bL1%in*= days:ragd dal Of zPPr1= *n %UbM1d2I) <, <br />'llVl <br />® CHECK BOX 70 EXPEDITE REQUEST-VOL00 FEE- €5Y' PROCESSED IN 3 BUSINM DAYS 2 <br />SIGNATURE OF APPLICANT •� DATE �„��V M7 <br />PROGRAM ELEMENTS SEARCH <br />. UNDERGROUND TANK (UST) MEMUP 899 (LOP) a Han'No AD^TEMENr <br />0 SOLID AM f AGILE <br />CI OTHER CLEANUP WM (NQK4-OM D FOOD FAaullr a sOuo Wau7E VFiiap� <br />LO UFiDERGR{}UNIi TANK (MOi�1trORIHCugtE EOVALa b' DOG KENNEL ® DAIRY <br />* , RAZARDOUs wASTE D pU QExERAXOR O CH=:EN RANCH D P ' PER <br />TRURU -:NT PANT <br />17 TIERED PVWrMO FACILITY O NtQi' UNOTEL i�ERCii1YARDlCHE>tt CU]L E75 <br />❑ TArTCAOOfBQDY FEttiCitiG Q POOLAPA G LAND USE APPLICATION UMNS <br />C2 ME OO WASTE BaCU.G 13 PUBLIC WATER SYSTEM a ani (PLiASg SPECIFY ABOVE) <br />1. List up to ten addrers"s In the space above. Select the t3"fs) of files from the List abave by checking <br />the appropriate box(es). At least one file type MUST be selected- FaXto (ag$1 46"138 or mail to the <br />-'dream iCtc9lcA- <br />2. EHD will notify the appilcant It any EHD file. exist. An appoinUnent for review will be confirmed <br />approximately rive business days taut no later than ten (10) days after receipt of aPPlication. The files <br />will be geld for a maacimUM of five business days for review. Appointments should be sc oduled <br />accordingly. <br />3_ A fife that is actively being worked on by EHO staff rnW not be immediately available for review. A new <br />application may be submitted when the file is available. <br />4� Any Elie not returned In the same condition as reloasegi will be reorganized by f HD staff at the expense <br />of the applicant. Future fl* reviews by the some applicant may require a $75.00 deposit prior to review. <br />*'iZNTATIVS alppolri to mt daM (must be aaMbm.d with iM staff. � <br />6- Appllcations received air 3:00 pm Will be processed the next bUSiness daY_ <br />CONFIRMED APPOINTMENT DATE <br />TIME <br />DATE CONFtR ED PHONE FAX INITIALS <br />t <br />s CH <br />