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/ Jan-06-06 08: 10A Kraz and Assoc 5598 2190 P .Ol <br /> DATE.REclrnrE"o e-etu LUCi raullnoen <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 Fast Weber Avenue, Std Floor, Stocktm CA 95202-2708 <br /> r Telephone:(209)468-3420 Fax: (249)4164-0138 Web,www.8J9ay.o*9/ehd <br /> ;' ii�BLI CORDS RELEASE APPLZCATXQN <br /> v PUBLIC <br /> BUSINESS7A FNCY' <br /> C1TY iSTATE' <br /> �6—�- <br /> AbbRl:�3: <br /> PiapNE i1( PHONE{ FACSIMILE_ <br /> TENTATIVE"APPOINTMENT DATE: -- <br /> (Ptamm allow 10 trualness days frAkwfte of application or <br /> Itral-•Tentsv"only-must be Gonflnned) <br /> C] CHECK DO%TO%XPEDat REQUEST.$93.00 FEE(CASH Olt CHECK ONLY)-REQUEST PROCESS IED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic ❑ ust ❑iMep-Desesiptlon <br /> information <br /> FILE ADDRESS E14I1 USE ONLY <br /> Sweet M Streei Name J city <br /> Z. <br /> 7C110r 'i7i � ° ` Unit <br /> i El nit 2 <br /> A <br /> 6. <br /> S. Unit 4 '\ <br /> 7. _E] <br /> g. ❑ Unit 6 <br /> 9. C Unit 6 <br /> 14. <br /> Specific Date Range of Information Raquested:From ,..� _ to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> R0*0%jK0 TANK(UST)CLEANUP SITE(LOP) ❑ Houaw.ASATEWle"T O sm D WASTE FxcurrrNFNrcLs <br /> R CLEANUP SITE(HON-LOP) ❑FWD FAraLITY M WASTE TIRE <br /> 06ROROUNDTANK(rMONITORrNOfflnWVAL) C7DOQKEWEL 0 DAIRY <br /> AZARwuswASTTGEHEMTOR r�CHICKB%RAkCH Q WASTEMUTEA�EATMENTPWIT <br /> ❑ rrkm PimimTTED FA6LITY ©IIRCTFL1FtQTEI ❑PUeM't'M TltV4tcl'�1►+L KEK+r�+ Tc>tLEn3 <br /> Q TATToWDoDY PIEWANG C?l'CCfLlSPA ❑LANO LAP APPLKATION SITES <br /> ❑ MFCmCALWASTE FACILrry ❑OTHER(PLEAK Speer - <br /> WEM AND SEP=PERarllr FtEc"DS ARE AVAILANLE FOR ReYet:w-MONDAY-FRIDAY 6:00 AM.6:04Pid - UtHl1G FiOLIOAYS. <br /> 1. List up to ten addresses In the space above. Select the type(S)of lilies troth the list abOYe by checking the: <br /> appropriate box(es). At least one file type MUST be selected. Fax tea X2091 Oo—"138 Qr:mall to the dress <br /> indicated a1N�a. Address ranges will not be accepted-for addlti'onal assiotance with fits addresses,contact <br /> the ENO.Applications received after 3',o0 pat will be processed the next business day. <br /> 2. The EHD will notify the applicant if any EHO files exist. An appointment for review w►►illibe confirme3(I <br /> approximately ten (10)days after receipt of app#Kaftan. The files will be held for a maximum of five business <br /> days for review. Appointment$should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immedlately available for review. A new <br /> application may be submitted when the file is available. expense of the <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD Staff at the <br /> applicant_ Future file reviQ"by the 8am6 applicitnt may require a$93.00 deposit priot to review. <br /> EHD 46-69 <br /> t017tltm� <br />