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E140 LOG NUMEMR <br /> SAN JOAQUIN COUNU <br /> A f F-0 8 2011 ENVIRONMENTAL HEALTH DEPARTMENT 1 <br /> 600 E.Main Street,Stwhon,CA 95 VN <br /> ENVIROWENiAL HEA1,11*00R ;(209)468.3420 F=(209)464-0138 Web;www,sjg0v.0rgldd <br /> PERMIT/SERVICES <br /> IAC RECORDS RELEASE APPLICATION <br /> A,P"OAN-r Abby Racco ausl wAoEwy: live Oafs GeoEnvironmerrtai <br /> AnoFew. 407 W. 09k St„Lobi,CA 952413 <br /> Pry(1): (209)3 9-1137;5 PHONE W: A9�.369 X377 <br /> TENTATIV&APPoIfaT9�WT DATE: ` 1 I( ( Tlme 9:04 am <br /> FA*aw aNaMr 10 bugWa 4W t0Mdw6r,of ep0k*b M --Tsai iw onEV-mint be eordlrmsd) <br /> f� i W BOX TOI'S rJM OR colt ONLY)-FWQUW P=M53W 94 3 BUSItt AS OAYS <br /> SIGNATURE OF APIPLICANT LATE 141 ff �( <br /> I^lec�s onia��: L�[.W Ll i�� r l� : <br /> 1°ILE Af�L?RIWss EMD USE LY <br /> �1trat>4 "mm Mann C>< © Lkdt 1 <br /> 149-7 w 2 <br /> s. 3'x-3�-o S' <0 S+ 0 ,, r <br /> 6. unFk a <br /> t5. <br /> 7, 0 urine <br /> 8. <br /> 10. <br /> app DaW RAMge of intot�iAgon Requell W;Prom alf svalfabl� to � �f <br /> E3rIV1RONNW7AL HI=Ai- <br /> 3 0 WAATP TWT <br /> MW <br /> $7fE(LOP) ©1 AW1TOAMT C9mmVpAuFAcw7YA p <br /> 0 FOOD FACumY 4112E <br /> rtT14RR OLEANUP&Te.01Ofi LAP) / 13 000 0 DAURY <br /> r 7au;c(Ello�amol2kNa7lt6tAan' G� QEIVAaaearAr P1AltT <br /> WAMM WAToF41 Q rP�°R TmXwj dAm)0c#id TONAL U <br /> rraa r-Aanrr� D Poa� 1.71 Uel APK$CATFW S's <br /> tl TATTDtaMMY PI9kCMH! a OTM:ft(PLemm Spero ) <br /> Q MMMLWA$TEfAVUTY <br /> WI.LAND SOY=PlIC my Raw"AlwAVA&MLE FOAPZMW • MQNQAY-FWAY 8S00 AM " NACUONO H"AY5. <br /> 1, est up Iso taw adaraasss 10 tlae app • mot�e tYi�ts1 a i1�s*0m afR list pbova by nbs�Adld"" <br /> 12 gm. <br /> box("). IOW one t1W MUaT be <br /> b .an(ea will not be aac4pprd far addStlonai aseiatanca with'US addressea,acntaGtb►M EfiU-Aglrtla�tHorts w+�+•d <br /> 8:00 pm vulU ba proaawsed Me nAxt business dayr�W VM to��tea(10) <br /> 1. The Em wdl no"tt►e a my a w lie kn 'Nbr for v*w. Appdnb"gft <br /> days ,r0041pt of� Tie Iwo 2Alk be hold for a MS* <br /> oillva d� re <br /> should be&Ww dulad accordingly. not bo lmedletety avalll M9 for rtvtww. A new ap0caV00 MY bw <br /> L A MW OW Is=uvely tM W19 www an by Fttp*to meY m <br /> =.be=ad VAN"so tie alb"by Em OUR at the expanse of tire � <br /> 4, Any ft Nat n�sWMW in stile m me ►w <br /> FuWfo Me fwAw ire by the ss� my fvq <br /> EHD u$E ONLY <br />