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.., ,... :.' TO 05B190a P.01 <br /> ,d SAN JOAitlU)N C011NTYPUBLIG HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION � rrr777 <br /> 3q4 EAST WEBER AVENUE,THIRD FLOOR <br /> STOCKTON CA 99202 <br /> (209) 468-U20 <br /> PUBLIC;RECORDS RELEASE� APPLICATION <br /> WPpL(CANr �rc`Ct�� Jc {�(\CSKJQ� 6USINESSfAGENCY <br /> M��.t•L L\�� l-tc �. C� <br /> A�oRess Q\ Et�vt DRa�+E N'3EQJ'3 , <br /> P-ONE�BOO `�'2.AY �- : eJ4 Cp\ �7.'.•�t-�lV <br /> TENTATIVE"gPPOINTlAENT 04T %-I\'Z\�, �^`-'�• _.�_.._ <br /> (Plaoaq ti�te 7,tv i0 bua,naSs as a Ir dal¢of TIME <br /> tcatlon submittal) <br /> CHECK BOX TO EXPEOITE REQUEST-$II'?m rEu-REQUEST PRESSPP 1N 1pBlUSINESS DAYS <br /> -SIGNATURE OF AFFLICAN-r - <br /> .,, DATE <br /> FILe ADORE55 ��-C""�'=- <br /> YHIS IDE EHD STAFF USE.ONLY <br /> PROGRAM ELEMENTS SCAROFJ <br /> XON <br /> SAV LQ�U� � -Lr,.-.intim o2q.G0 K <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> u NOER.BROUNU TANK(UST)CLEANUP SITE(LOP) 0 HOUSING A9ATEIAENT <br /> OTHER CLEANUP SITE(NON-Lop) C3 FOOD <br /> PACIUTV D SOLID WASTE FACILITY <br /> UNDERGROUND TANK(MQNTFORINGlREMi]VAL) ❑ DOG KENNEL O SOUL)WASTE VEHICLE <br /> O HAZARDOUS WASTE GENERATOR a DAIRY <br /> TIERED PERMMED PACIU Y 0 MOTEIUNk � 0 PKG TREATMENT PLANT. <br /> ID TATTODI600YPEIRCING 9 POTE"NO3PA -L$ D PUMPER TkUCKnAROICHsm Told=TS <br /> t3 ME WCAL WASTE FACILITY ' ❑ LAND USP APPLICATION SITES <br /> PUBLIC WATER SYSTEM CI OTHER(PLEASE SPECIPY ABOVE) <br /> 1. List up to ten.addresses in the space above. Select the type(S)of fiISS fro <br /> the appropriate box(es). At least one file tym the List above by ehecdng <br /> pe MUST be selected. fi t 2 9 4s i3 <br /> addrR S inq ted above mail the <br /> 2. EHD w111 notify the applicant if any EHD files exist. An appointment for review wilt be confirmed <br /> approximatefy live businessdays but no later than ten(10)days after receipt of application. The fires <br /> will 4e held for a maximam of Fva business days for review. Appointments should be scheduled <br /> accordingly. <br /> a• A file that is actively being worked on by EMD staff may not be immediately available fpr rLY16W. A naw <br /> ?Pplicatigh may be Submitted when the file Is avallable. <br /> 4. of thQ Any file not rktUirn" in the same condition AS reteased will be reorganized by EMU Siaff at the expense <br /> 5. 'TENTATIVE appo ntmelt fie reviews by the must be Confirmed With with nt May <br /> y re vire a $37AD de <br /> S. Applications received after 3;00 pcn will be processed the next business day. Posh prior to review. <br /> i <br /> CQ NFIRMED APPOINTMENT DATE <br /> I TIME <br /> DATE CONFIRMED <br /> PHONE PAX INITIALS <br /> REJi WED YESl—"�— <br /> mz , �e a� rwo NO REVIEWDATE <br /> TOTAL P.01 <br />