|
6it7:e/21 2,;I 47 7-325964285L(:" TSG rte:; 9,2
<br /> MEN SAN JOAQUINT COUNTY •
<br /> F -0 L ru G IN JIM.B L,R
<br /> ENvu, OMWNTAL HEALTH MPARrywj�q
<br /> "x 006 304 Ea-st Weber Avenue,3"l Floor, Stockton
<br /> CA 95202-2708d,
<br /> TOCPNIIHP,c `09)468-3421)Fax-(209)464-0138 Web:w-N-wz45,qov.o-k_z/ehd 3
<br /> mn1 �VI,QES PUBLIC UICORDS RIELEASE APPLICATION
<br /> 7131.13WESSIAGENCf. 71,e
<br /> — ,
<br /> NONE(2)'
<br /> TEN TJA 7VE"�APPO�'117TUENT ONTE:
<br /> ff"Rm'�ZR0W 10[M Iia days frinm d,-Am Of 3111111@40n Submigal
<br /> ^f-01W.We On)"-mtmt Im mvpfirr.,W.�1
<br /> PX 'E. REQUi-,,03T-39CUO FEE(CAS-H OR CHECK ONLYI-REQUEST FWGF;$Ev 1A 3
<br /> C APFWCANT
<br /> DATE
<br /> FILE,APORFS$
<br /> -F EHID USE ONLY 7-1
<br /> Zow, Stfmvt 9�,amo cff�y
<br /> �1
<br /> t! 'P',.k
<br /> r,
<br /> A,
<br /> Poll
<br /> 2
<br /> M
<br /> r-aftt .Rptse Of h'OrmuV"3114 R--qi-iested:Fran to
<br /> ENVIRONMENTAL HEALTH DEPARTMENT FILU
<br /> �;r.EANVP SFS(Lapp 0 Hoc iNQ ARATIZMENT 9 swcwAsu Fmu-nivo�w-u:
<br /> A%Nup ZWsz-,(Nw�H".0p) 13 1-700D FACILITY fdWAt,1-rnFM
<br /> P'L rJ 000 KENNEL xoxrm,
<br /> V '�-—. r p i 7-;V!A,,07 CPq-HIMMN RANCH7
<br /> -WWA97XWATZRnE,%'NF:':V -
<br /> V MOTELIHOTEL -41
<br /> POOLISPA XLaim Uss Apmr.AVOF T-7.13
<br /> WASTE Fm-mm, Cftnmt(PLF-ASE
<br /> WELL A!4P SOPVC PERMF FECOA02 ARE AvAILABm FOR pjmEw-ftrimy-FmDAY$-.Do IW-S:Wpu - rmr,up(w mougms.
<br /> ur tm PPacs above- Sefe"A thO"(3)Of MAW fmm the 11p;t ab-ove by chucklqu,the gppropriatu
<br /> Kt ie�tt one tip tyae MUST he selectad. _Fax to 209)404-0138 Addmms
<br /> V.1iff not km for iWiflonal assk4tanee with file addre"as,qonto.ot the END.Apprkv..#.jt-),n*rectivel.f'A-el,
<br /> Wr-ts day.
<br /> 4,th:1 a s
<br /> Veit;n frffj Rpp!1p,%rt 4 wy END files 0XISt. An appolnbwnt for Ing v will be con. ed appr in te,
<br /> Aev Inr 0A a py';ap
<br /> di-,ra Oker rp-a-alpt u;appvcation. Thp,files will he field for a MAXI num of ffw business days for revsw- AppOnilnerAz
<br /> Vhollled be nehedule'd a�w;qr4ing'Y'
<br /> A file vhzt!v,AiQi€vcpjv hp,,P4.1 ws Wed On by EHD St,
<br /> Iff May not he Immediately available for review. A new app11cqdQn qiAy b
<br /> is av;;i%blk% e
<br /> .4,T,
<br /> -m pvt f,!Iurne",M,151@ zamwnvnjifion as mif"sed will be morganizod by EFC! the exfxr�.qc of ft.
<br /> EMD USE ONLY
<br />
|