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B. -25' 05(FRI) 17:02 VERS[_ INC, TEL:9uQ622618 P. 002 <br /> ENVIRONMENTAL HEALS"' P"GE 131Q2%i3/2k1kt5 11:96 4699136 *40fcn,+LuValvumoen <br /> SAN JOAQMN COUNTY <br /> nLSI>;Imo! 'tl EENVIRONMENTAL HEALTH DEPARTMENT <br /> F"-" <br /> .' 5X005 304 F,aat Weber Avenue,, 3'4 Floor, Stockton, CA 95202-2708 <br /> Telephone: (209)468-3420 Fax: (209)464-0136 Web:www•sjg0v.07`9/eh6 ' <br /> E<dVIRONN4E(VT HEALTH <br /> PEPM1L/SE8VIQE.q PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT. SUSINESSIAGENCY: 4+.[;.._��=---- <br /> PHONE 0): °lily �(a3 ' �13HONE1711 FACAIMIL6: gIL—� <br /> TENTATIVE'APPUINTMENT Pate: Time: <br /> (pleas*allow 10 business days from data of applloation sutrmlttul--TeNAlive only.must be confirmed) <br /> M CHECK BOX TO EXPEDITE REQUEST-$97.09 FEE[CASH OR CHECK ONLY)-RFQu6aT PROCESSED IN�a SI E86 Y <br /> SIGNATURE OF APPLICANT DATE <br /> 4NIT OIaTRIauTION un111 Unit 2 "1 Unit 1 nR 5 Unit B ❑ Other(Uec ron c Is map <br /> FILE ADDRP9& ,,,___ ITHD USE ONLY <br /> Street city "— <br /> Street# _— <br /> L`� U4T1. a ►tl� ar. <br /> — <br /> R• 2 uti <br /> r <br /> ) ) <br /> Specific Oata Range of information Requested; From to , <br /> ENVIRONMPNTAL HFALTH DEPARTMENT FILES A <br /> (>}SOLID WAVE FACIUTYNENIC�a <br /> jIINpEgGROUNp TANK(UST)CLEANUP SITE(LOP) R000ING ASATEMeNT LI WASTE TIRE <br /> PTHER CLRANUP SITE(NON-LOP) IM POOP FACILITY <br /> (((������ppp ❑000 KENNEL L9 OAINY <br /> UND[ROROUNp TANK IMCryITORINGIRF�^�all (7 CNIOXEN RANCN .�WAGTFWATER TNaPTMENT PLANT tr• <br /> Ifni HAZARDOUS W01t GENERATOR 17 M IOKFN AN arPuMPaR TRUCKNARnICHEM TOILFTS <br /> )a TIERKn PFRMITTED FACILITY ,0 po rsoH 0 LAND USE APPLICATION SITGG <br /> 0 TATTOOIBOPY PIERCING M 01HER(PLEASE e01101M <br /> IrMEOICAL WASTE FACILITY <br /> WELL AND BEPTIC PERMIT Re00APG ENE AVAILAPLE Fog REVIEW - MONDAY-FRIDAY 1:00 AW&OOPM - EaCLUOING aupa s. <br /> 1, List up to tan addressee in the space above. Select the Wpa(s)of filer.from the list above by checking the <br /> p pct-0138 fir all t0 tha a dr0 a <br /> appropriate box(es). At least one file type MUST a selected. F a oto l <br /> indkcatied�bove. AddrEss ranges will not be accepted—for additional assistance with file addresses,contact <br /> the EHD.Applications received attar 3:00 pm will be processed the next business day. <br /> 2. The EHD Will notify the applicant if any FHP f[1os exist. An appointment for review Will be confirmed <br /> approximately ten(t0)days after receipt of application. The flies will be held for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that Is actively bbing eworked on by d when the file H13 a a Ilf may <br /> not be Immediately available for review. A new <br /> application may b FHD at the <br /> 4. Any fits not fstumed In the same condition as released ylrequir ,11$9 oo deposit priorfto reviewPensn a t s <br /> applicant, Future rite reviews by the same app <br /> ppo a.m-006 <br />