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07/27/2006 THU 14:16 FAX 001/UUI <br /> ------ <br /> IM\� ✓ IE D SAN JOAQM COUN FY EHD LOG NUMBER <br /> ENMONNIENTAL HEALTH WPARTM iliT O <br /> JUI., 2 7 2006 304 l3ast Weber Avenue, 3rd Floor, Stockton, CJ's 95202-2708 <br /> ENVIRONfvlEfdi HEALTH Telephone: (209)468-3420 Fax:(209)464-0138 Web: www.sjgov.orgiehd <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION _ <br /> APPLIC:ANT:.� BUSINesS/AGENCY; <br /> ADDRE7 <br /> SS:�0-10 025 4414 19Lf ft,�n <br /> PHONE.11):�J.SL�'� —(L,(,� L_-PHONE(2): FACSIMILE; <br /> Tf;NTAITIV'E"APPOINTMENT DATE: <br /> (Please allow 10 business days from data of application wbmiUal-^Tenr36116 only-must be cenfarmed) <br /> CI CHECK EGY 1.0 ExPliDrm Moir $83.0 FE CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BU$IHE:s DAYS <br /> SIGNATURE OF APPLICANT ___� o_1V 116/Il DATE <br /> U181TDISTRIBU1101V C7 unit ❑ Unit 2 Unit Unit 0Unit 6 O Unit6 ❑ Cnher(dxtnxACAlu-tslmaps) �I <br /> FILE ADDRESS <br /> Sheet 4V-1--�,,�,.� Street Name - city EHD USE ONLY <br /> 2. <br /> 3. <br /> 7 — - — <br /> Sp=fic Data Range of Informadart Requealed:From to `I r'/ra' ZZL-i <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILEv, <br /> kNDeiwitoum TKIn(UST)CLEANUP SrrB(LOP) O HOUSING ARATENENr E7 soup wAsTE FAcr.rr/NrNicLe <br /> OTHIER CLEANUP S[Te(NON-LOP) C3 FOOD FAcLny 0wa:rETIRP <br /> AUNr,IEROROUNDTA111c(MONt1ORaWRFMOVALL) ❑Doe KgNNEL ❑DANT <br /> ❑HAZARDOUS WASTE QVICFATOR O CHICKEN RANCH ❑WAb1EwATERTRFr:1N m PLANT <br /> ❑TIEPED PHRHITTEO FAOILITY d rdoTMJHOTEL C7 PUraPERTRUCK/YARD/CHm TOILET. <br /> U TATTOofEoDY P ire aRR O FOOVSPA Q LAND USE APPUOATION S Us <br /> C7 61MOAL WAST[:FACILITY ❑OTHER(PLEAB6 SPECK_ ,� <br /> WELL AILD SEPTIC PemArr REp)RDS ARE AVAILABLE FOR REyew- MONDAY-FROAy 8:00 AM-6:00RA - ERCLUDINA HIoupAys. <br /> 1. List up to tan addresses in the space above. Select the type(s)of files from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax to(2091464•-0138 or mail 1 tQ he adtlers._ <br /> indlca(:ed above& Address ranges will not be accepted-for additional assistance with file addresses,contact <br /> the EHD.Applications rece2ved after 8:00 pm will be processed the next business day. <br /> 2. The. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately ten (10)days after receipt of application. The files will be held for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 8. A file that Ls actively being worked on by EHD staff may not be immediately available for review. A new <br /> application may be submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> Uii, f <br /> ENodecaogs , <br /> 1ndIQ6 <br />