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EE. -25' 05IPR1] 17:02 IrERZ " INC, TEL:9' A622678 P. 002 <br /> Er�vIRQNMENTHt- <br /> FA,;E �? <br /> R2 I/20M 1 CR{J I.W�3 IY UIYIOr Fi <br /> l"—r-" <br /> SAN JOAQVIN COUNTY <br /> � <br /> I- ENVIRONMENTAL HEALTH DEPARTMENT <br /> F� 304 East Weber Avenue,3 Flpor, Stockton, CA. 95202-2' 08 <br /> Telephone. (209)468-3420 Fax: (209)464-0.138 Web:WWW,sjgov.orglehd <br /> ENVIRf-PST-HEA1 TH <br /> I'ERN1IT;,E;��f , L <br /> PUBLIC, RF <br /> CORDS RELEASE APPLICATION <br /> APFLICANT: ►► SUSINt` - <br /> PHONE li): <br /> � �l3d.�'ti0NE131! <br /> TENTATIVE" APPOINTMENT GATE; Tim, <br /> (pleass allow 10 business days frD;Alto of appllctttiarl submittal-'renfAfive aMly•mutt be conflrmsd) <br /> M CH5CK BOX TO>XPEDITF-AQUEST•$93,09 ME(CASH OR CHECK CKY1-RF-0UF-STFRQCsSSFD IN 3 BtJS'NESS A�Y.S <br /> BATE <br /> SIGNATURE OF APPLICANT _,..,# <br /> UNIT f31STRIaIJt10N <br /> Unit Olt 5 Unit a p Other(alae roll Ls msps <br /> FILE AADRSiT-�,. ITHp USE ONLY <br /> _street D Street Mame City <br /> '`'��vV.sT 7. 1.+•t l�_ .�� � <br /> tw�`F#5 4• <br /> 1 _- .- <br /> �� ) 1 <br /> to <br /> specific Hata Range of Infomrstion Regtuested: Frain — s <br /> ENVIRONMENTAL H'EA1,TH AEPARTMENT FILES, <br /> CQ SOLID wAcr�p,cil.IrYNEIiICLE <br /> bf({QusING ADATERENT Cl SOLID 71119LENge}tGR❑UNP TANK(tlSTl C1 EANllla SLTE(i.oP) ❑1CODP FACILITY OTHER CL>=ANUP 5171 (N4N•� P) 1711500 KENNEL• L4 ON S-rPLAPT AN= <br /> ( UNoe cmurAD TANK(MaNlYnflirEGlfksm +at1 f�CHIcKFIN RANCH �WABrTFi TFi c;KN ARn1EHT MT01 <br /> HAZARpou,.Wks-p:00<RATOIt 0 MoreUNoTCL OPPUPPER TRuGKlY4Rn N SIT�ra fTs <br /> T IgRf p PmMITTED FAGtUTY U POCILISPA Q LAND UsE APPWCATION SITcc <br /> 11 TATTO01000y PIERCING p OTHER(PI.EASC SP9dIFY) <br /> PVpfIEO{GAL WASTE FACILITY <br /> WELL AND GUTIC PEfiM1T R@p0RG6 ARE AVAILA13LE FOR REVIRW MONPAY•FAII�AY A:Oq AM 3:90PM 1 xGLUI]ING GLItt <br /> List u to tan addre$eL3s in the spar-%%;above, $e#ect the ty ce{s)a fi �m�h ist o eve by Gftie add the <br /> 1 appropriate <br /> box(es), At least one file type MUST be eelL; <br /> Ot d. oil the address <br /> indlca�I�d�, Address ranges will riot be ac I �$ ae�essedthe next business daitional assistancD y File addresses,can <br /> the iTNIJ.App14eatiane resolved aft4r�:p0 pm w P a alntment far revio'iN w111be confirnitjd s <br /> 2, The EHD'Will notify the applicant it an ��P files exist, An PP <br /> a rfaxtmata[y ten(I a) days aft¢ti receipt of appllcatiohcoard�lalywilt be held for a maximum et live business <br /> pp Appointments should bo scheduled a !d <br /> days for review, 1?�p <br /> 3, A file that Is activety being worked aft by SHA staff may <br /> not be Ift11f'tediatelY a�+aileble for rcvie�l, newa of the <br /> application MAY he submitted when the file Is FHp staff the <br /> 4. Any File not returned In the same condltipn as c�fnle at m ysod tfequirell he O4$93.00 derganized po tt prior totrevi w, <br /> applicant, FutUre file revtets by the same aPP <br /> fHE AgAg-009 - <br /> „r13:04 <br />