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SAN 10ANIRECEIVDironmentai Health Department <br /> 1 PLIS-I RECORDS RELEASE APPLICATION <br /> MAR 2 � �,�r r�Alt <br /> 0 EHD-LOG Nt1MBER: 0 <br /> (481'5 <br /> APPLICANT �irrra��,,{, ----�/S�t1SINESSI AlENCY �3:rl <br /> ADDRESS, 2' - � . _ _ mid tr.,aI�y <br /> PHONE(1): � 507753 PHONE(2): FAX OR E-MAIL: <br /> _ - _. — <br /> Please allow 14 business days from d to of application submittal for the records to be available, <br /> Staff will contact 3r to rrar e a ppointment date and time to review the requested records, <br /> SIGNATURE OF APPLICANT_t' .c_ C ; DATE <br /> 1. List up to ten addresses in the space below. A dress ranges WELL NOT be accepted. Select the typa(s)of files from the <br /> list below by checking the appropriate box(es). At least one file type MUST be selected. Fax to(249)464-81.38.mall to the <br /> address indicated below,or email to info&sicohd,com, Applications received after 3:00 pm will be processed the next <br /> business day. <br /> 2, For assistance in identifying the nature and content of EHD records,please contact EHD at the number noted below. <br /> 3. The EHD will notify the applicant if any EHO files exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly, <br /> d_ Any Fila not returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant, <br /> Future file reviews by the same applicant may require a$152 deposit prior to review, <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 9:00 AM-5:00PM{EXCLUDING HOLIDAYS) <br /> Electronic Information: 1 List [] Map— Description: _ <br /> Specific elate Range of Information Requested: From to <br /> ENVIRONMENTAL FILE ADDRESS — — <br /> HE=ALTH DEPARTMENT EHD USE ONLY <br /> FILES <br /> ti5avr:ll aCdr9SsB5 oral} a lcrass ra^has will nor Vv:-ra raaj <br /> Lxi ur.j(,j,c.:r„r,,.. - Slraot# Street Name City <br /> � 3440 East Main Strut Stockton t <br /> x❑4rk5vL4�o�n�T.rnl y --r _ -.._ _.. <br /> !_I$T 1MnrWt..rlr:! <br /> El�% <br /> �1 I <br /> 4 <br /> "111 <br /> qw- <br /> Czar} ! —J /O <br /> Pyr.p-Tru::% <br /> B <br /> ®'ii e9'l�CY1rZ.'1'.rr.:IL I�E'!a w`w�ll �♦__--- ._.. 4'Cl�';` <br /> ! <br /> ❑-i:9i.:-r> ot.a:r.'"ani 1 T AFT'-W rnN <br /> El1 <br /> El <br /> �^'`� 9i g r iS_ <br /> n%ic;NE rl V weir i;vll y <br /> t <br /> 17 r"M4r di+} <br /> (Det' <br /> `...BOXED AREA-EHO USE ONLY••- <br /> �i- `I- l=r-t.LileJl � �r��Sl f` Jk ,�. �� '��-r-�v� e�.s�T,.',� idc:. �n�.yz{�, � ✓,/�•�"v ��- <br /> - <br /> 0 Records provided by Staff-PPR Complete. swTr N.ima EK'0"- s <br /> 1,-,,535 E, H@zrei,'C.n Avenue I SlrCklon, California 952051 T 209468-3420 l' F 209 464-D13,5 l vAi.,w.s ce: d -,cm <br />