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ENT BY: LUSTRE-CAL NAMEPLATE; 200 334 6394; NOV-12-03 5:25PM; PAGE 1 /1 <br /> 12( 003 g 209461 J3 FIFTH FLOOR PAGE 01 <br /> uu Loa au�ean <br /> JOAQUIN <br /> COUNTY <br /> NOV 1 2 2001 SANTAL HIF-A TH DEP <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 3Wt FART WEBER AVENUE,TMRD FLOOR <br /> ENVIRONMENT HEALTH STOCKT'ON CA 952LJ2 <br /> PERMITISERVICES. (209)488.3420 . <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT r's. / r7' BUSIMEsaAGENCY G'SylFYG,yo- <br /> aDDraae l/ Trrlsv -�F G.�,✓L� �d Aic v�6 <br /> PHONE — FACMADLE Io <br /> TENTATI)&YAPPOIN TENT DATE l/ TOM r7:OVp�_ <br /> (Flew Srve T m 10 a .rma aye hem d.b of aPPuauon auMNlrq� <br /> ❑ ^,4� <br /> CHECK BOXTO LixPEORE RlQUE8T.p9 REgUE8Y IN!BUSINESS DAYS { <br /> SIGNATURE OF APPLICANT DATE 11AV ) <br /> FILE ADDRESS THIS SIDE EHD STAFF USA ONLY <br /> PROGRAM ELEME SEARCH <br /> i I Y• <br /> 3 <br /> ENVIRONMENTAL HEALTH OM31ON FILES <br /> O.UNDMGROUNDTAXK(UST)CLEMUPSrrE(LAPJ ❑ HOUSING ABATEM ENT O SOLID WASTE FACILITY0 OTHER a1ANUP SDE pHON{OIq 0 rOOD FACILITY 13 8CUO WASTE YBNI= <br /> UNDapd1DUND TANKMERAORINOmEMWAL} O ppG�iN C DAIRY <br /> rriNJtXDOVB WASTE GETIERATOR 0 CHICKEN RANCH 0 POW TREATMENT PLANT <br /> TIEREDPFRMITrpOFAdUTY 0 MOTELIHOTEL 0 PUMPERTR1XWYAR000HEMTOEPTa <br /> 0 TA�T001500Y PEIRCING ❑ POOU PA D LAND USE APPLICATION arras <br /> 0 MEDICAL wASrE rACLrrY ❑ OTHER(PLEASE SPECIE`() <br /> 1. List up to ten Addresees in the apace above. 8elsct the type(s)of files from the flat above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fu to(2091484-0138 or mall to the <br /> addrsac <br /> Above. <br /> 2. ncte <br /> applicant If any EHD files exist An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10)days atter recalpt of application. The filet <br /> will be hold for a maximum of five buslness days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that Is acvveb being worked on by EHD staff may not be Immediately avallabke for review. A new <br /> application may be submitted when the Ate Is eyviiebie, <br /> 4. Any file not returned In the same condition ee released will be reorganized by PHO staff at the expense <br /> of the appilcant. Future file revtsws by the some applicaret may require a$89.00 deposit prior to review. <br /> 9. 'TENTATP/E appointment dates must be confirmed with EHD steff. <br /> B. Applications received atter 3:00 pm will be processed the next business day. <br /> T. <br /> _ _ _ �isitAriliea(x�5JK1:•� •- `Tq�I� _ - — -- -�- .___ <br /> • . - <br /> - — - - _--INNlA1� <br /> >mm� <br />