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From MARCUS H BOLE AND + CIATES 530+633+0119 1/2007 16:40 #404 P.001 <br /> e>tei2ee6 1e 5r, - <br /> 4640138 <br /> � J ENVIRONMENTAL HEALTH PAGE 81 <br /> OAQUIN COUT(Ty <br /> APR, 1 1. 2007NM .WALHEALTH DEPARTMENT <br /> 304 Past Weber Avenue,30 Floor, Stockton,CA 95202-2708 � <br /> Telephone:(209)469-3420 Fax:(209)464.0138 Web:wwwsjgov.org eh 5O <br /> PUBLIC RECORT s RELEASE APPLICATION <br /> APPLICANT: I <br /> ADDRESS: BUSINESStAGENCY: <br /> PHONE 11)_ 0-6;7?—ii//7 PNONEM:9%-7//7 e[p/ <br /> 1EN Pka"a'APPOINTfAENi DATE ///7 <br /> ILF <br /> (Pkaaa allow,10 b441ness days arm d to or appp�j-. Time: <br /> rmGGve oMy•mus!-moo eenli`mgdl� <br /> CHECK BOX TD EXPEDITE REQUEST•;9_1A0 PEE(CASH OR CHECK MY)^REQUEST PROCPSSED IN a BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE `1111/5i <br /> IRlfr O15TRl0UiKN1 13Unn1 OUnit2 Utdt7 C]Un7t4 'MUnit6 0 UDn6 ❑ Otlror <br /> (Ne�h'oMClns WnfapS) <br /> FILE ADDRESS <br /> s0 a Street Ramo EHD USE ONLY <br /> �2. <br /> a. r 0 4u <br /> 4. �aT <br /> C� 6. <br /> 7. <br /> ry <br /> B. is <br /> "SPerMc Date Wl hV of Information Requested:From to oda' <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> r�}IMIDERGROUNOTARK wuvS7s oP) MENT 08dJbWA3M <br /> FA*UYKEtaCUETHERCLEAHUPSITE CI;� ❑FooF� 13WASTETaIE�UHOERp <br /> TANK(MmaroFwalREmcvAL) 0 Doc KEHHS P tumY <br /> O nvaADoirs WAM G009PATM O cHcW RARcH ❑Wa,^.T6wA1EA TREArrEHrPWrt <br /> d TATTOUBODY PERCRO 'O PPDUSPA - ❑LAtrp'Use APpucAruH SM <br /> 11EDK'.AL WASTE FACMY ❑On&R(PLEASE SF'Ee&YL <br /> WELL AND SWYO PERYT REOMOS Me AYAuxiuE f0R REVIEYi- a1DNDAY FRpAY a':eO AMS:Oow - F]kta110a/D HUWAYs.. ' <br /> 1. List up to ten addresses In the space above. Select the types)of tiles from the list above by checking the <br /> appropriate box(os). At least one rile type MUST be selected. PM.to(2091464.0138 or mail to the address <br /> Indicated above. Address ranges w01 not be accepted-for additional asslatance with file addresses,contact <br /> the EHD.Applications received after 3:00 pm Will be processed the next business day: <br /> 2. The EHD will notify the applicant H any EHD files 0XIS1. 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 buslness <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that Is actively being worked on by EHD staff may not be immedialety avallable for review. A new <br /> application may be submitted when the Nle fs available. I <br /> 4. Any rite not returned In the same condition as releasod Will be reorganized by EHD staff at the expense of the <br /> applicanL Future file reviews by the same applicant may require a;93.00 deposit.prior to review. . <br /> i <br /> _r <br /> rain, t <br /> A <br /> END uAa�s - . <br /> ttR39/ <br /> 1 <br />