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09/29./2006 11.:25 FAX C 002 <br /> EHIE)LOG NIJM�--_F <br /> MDSANJOAQUIN COUNTY <br /> nECOED VEiN-%,.TRIONMENTAL HEALTH DEPARTMENT OZ <br /> 304 East Weber Avenue, 3d Floor,Stockton,CA 95202-2708 <br /> SEP 2 9X006 <br /> Telephone: IkN9)468-3420 Fax:(209)464-0138 Web:,,Nww.sjgov.org/eh, <br /> ENNONMENT HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> PE:RM1TWVCE§= <br /> 'AV L —BUSINES51AGENCY: <br /> 6-tl U111 L <br /> ' _L� d��k` <br /> ADDRESS: 0 W <br /> PRONE(1): PiHONE(2): '�i7-715& FACSIMILE: 2, 7 Z7 <br /> TENTATIVE;'AFFOINTMENT DATE: Time: <br /> (P-feaea a;€ow 10 busincss days from date of application submittal 'Tentative only-must be cc nfinvcd) <br /> ­;SGIK BOX TO EXPEDiTE RE�Ai� (C <br /> T-$93.00 FEE ECK ONLY)-REQUE3T PROCESSED:N 3 ZIJSIN <br /> $IGNATUPE OF ©ATE ir APPLICANT 07 <br /> +Ji�l� DIST!'•(iBUTi�.+N �Unit 1 © rJnit 2 �Unit 3 ❑Unit 4 �Unit 5 � Lint 6 � Other(e'ertrcteie<'ila'�!¢napoFp�-_ <br /> ...... ..... ..... <br /> 5 5746 <br /> 6 ,LVE TPA& U11SNIXV ft <br /> - . TI <br /> 4_4 4, z.- Z T MkiE., <br /> . 6.42 <br /> 51 <br /> _P 105 Vj ir. <br /> k5.'5-. 23c <br /> 14 'T <br /> 1, <br /> LLS-r A <br /> 9 Q15 <br /> 9fa <br /> — 1. <br /> -77-17 QTA_�.TVJ. :_­ 7 <br /> 'it __7i jAj )-io, 5T -+(,4 <br /> -4- lam J-2— <br /> Specific Me-to Range Of Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FtLE—S <br /> '.;.,�neqc-Roum)TAW,(UST)CLEANUP (LOP) 0 HOUSING ABATEMENT LEr <br /> XTHESO <br /> CL=-ANUP SITE(NON LOP) 0 Foot)FACILITY 0 <br /> ?KIJNoFRGROUN1;TANK(MONITORIN31REMOVAL) C3 DOG KENNEL <br /> KH.02-ARDOU-S WASTE GENERATOR C3CHICKE CH J JREATMEWI PLAN'T <br /> �'',E?ED PERMWMD FACILITY 0 L F 0KfYARD/c111EM'MLFT$ <br /> 0 TA—,oa!�Y PIERCING 0 FOOLIS APPLICATION$4 TES <br /> 11 WASTE FACILITY 0 THER( LEA -Sr Ul <br /> iio.,G" H"OL I C <br /> — <br /> WELL AND SEP'BC PE:.RMIT RECORDS ARE AVAILABLEEVIEW- MO XCI U;D;NG Alga <br /> List 4r,to ten addressIn the space above. Select the e of fil 9 )m the list above-0y checking the <br /> es <br /> appropiiate box(es). At least one file type MUST be select Fax to 091464-0138 or mail to the adds <br /> ens <br /> lnndir�atad above. Address ranges will not be accepted—for additiona assistance with file addresses,conta <br /> the El D.Appilcations received after 3:00 pm will be processed the next business day. <br /> be confirmed <br /> The E.F0 will notify the,ZpPfttant if any EHD files exist. An appointment for review w' mmof five bvs!fless <br /> a.p p - , <br /> -C.0niately ten(101 daye�,fker receipt of application. The files will be hold for a maximu <br /> Appo'Otmants should be scheduled.accordingly. <br /> h,falx r la acdveiy be'rIng "or4ed.on by EF�D staff may not be Immedlatoly available for revievi. A -new <br /> appitc-atlep may be-submitted when the file is available. <br /> 4. Any fele not retumed jr,,the same condition as released will be reorganized by EHD staff at the exoanSe Of the <br /> -an <br /> pii".m. Future file reviews by the same applicant may require a$93.00 deposit prior to review <br />