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12---e2-1509 Gad : 21 PM r 4 <br />MYp s2 Ft Y-NFn <br />TO 14134--00 P. k �r <br />EHO BOG hk"D i. <br />SAN jOAQUIN COUNTYPUBLIC HEALTH St_KViGE$ + <br />ENVIRONMENTAL HEALTH DIVISION <br />304 EAST WEBER AVENUE, THIRD FLOOR / <br />STOCKTON CA 95202 <br />me (ZU9) 4U-3420 <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPUCANT tn 0L I f}"LL L lqM C' DUNNEWS AOCNCY <br />AZDRFES '10 ` <br />PHOMt% i ' �� / FACS*AILE <br />X11 5 Tek T -S A"F" �,,,ZS, G� �i►v� <br />TENTATIVE-1APPoe r-mFNTDATE 12-17 '?B 13- L13 I`/ &E - - - - - ----- <br />(Ps�xa glue r to � 0 bustnvu days from gala or apy�icauen submtml) <br />A. L -C tF-,e NA --1 v 0 <br />CKff(; { 50XTO WEDrrE R,EQU Of - REQUEST PROCES IN 3 BU31WE9$ DAYS <br />SIGNATURE OF APPLICANT � DATE -2, <br />ENVIRONMENTAL HEALTH DIVtSIOU FILES <br />r UPERGROUND TANK (UST) CL.EMUP SITE (LOP) <br />CLEANUP SITE (NON -LOP) <br />FILE <br />ADI)t:BS <br />UNDERGROUND TANK (MOWORINGIREMOVAL) <br />i bJhVE, <br />k)- <br />LA -ST <br />❑ CHICKEN RANCH <br />d PKG TREATMENT PLANT <br />❑ 719"D PERMITTED FACILITY <br />❑ MOTLL1116TEL <br />❑ PUMPER TRUCIVYARDIGHEM TULETS <br />D Y 1VE <br />7DGK t�J -- <br />d..t♦.ST C *-T'E� Lt $ 1 _s <br />-2,57 Z � <br />o PUBLM WATER SY- �.m <br />❑ OTHER(PLEAS SPECIFY A50M <br />It N A v t V u <br />'S OC4--ro N - <br />!, A ST I- 14C -r <br />> <br />dill NAQV 2(U� <br />'ill£ ICON <br />iLS7 r2X�E` Ili --- <br />i <br />ENVIRONMENTAL HEALTH DIVtSIOU FILES <br />r UPERGROUND TANK (UST) CL.EMUP SITE (LOP) <br />CLEANUP SITE (NON -LOP) <br />❑ HOUSING ABATEMENT <br />0 FOOD FACILITY <br />❑ SOLID WA37E FACILITY <br />C] SOLID WA4TA NIMCLS <br />UNDERGROUND TANK (MOWORINGIREMOVAL) <br />❑ DOG KENNEL <br />o WIRY <br />L7 HAZARDOUS WAMM (1EKRATOR <br />❑ CHICKEN RANCH <br />d PKG TREATMENT PLANT <br />❑ 719"D PERMITTED FACILITY <br />❑ MOTLL1116TEL <br />❑ PUMPER TRUCIVYARDIGHEM TULETS <br />❑ TATTOOABOPY PEIRcmr. <br />O P 0LISPA <br />O LARD U�E APPUCAT;DN 3iTES <br />n ME XCAL WAgTa RACJUTY <br />o PUBLM WATER SY- �.m <br />❑ OTHER(PLEAS SPECIFY A50M <br />1. Lint up to ten addresses In the Space mbgvo. Select the type(s) of files frorn, MQ list above by Chocking <br />tfle appropriate box(es). At least orkt file type MUST be selacted. Fax to (209) 04-Q 8 or mail to the <br />address Indicated above. <br />2. EHD will notify the appUcant if any et10 files exist An appointment for review will be confirmed <br />approximately five businwm days but no later than ten (10) days attar receipt of application, The fifes <br />will be held for a Maximum of five business days for review. Appointments should be scheduled <br />accordingly. <br />3. A file that is actively being worked on by EHD staff may not bo immediately avallabla for review, A now <br />appli¢atlon may be submitted when the filo Is available. <br />A. Any Silo not retumed in the same Condition as released will be reorgalnizod by END staff at tho Renee <br />of the applicant. Future file reviews by Vie Same applicant may require a $78.40 deposit prier to roviaw, <br />d, *TENTATIVE appointment dates must ba confirmed with EHD staff. <br />6. Applications rDeeived after 3.04 pm will be processed the next business day. <br />.nzo. <br />TDTAL P.©2 <br />