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Jan 29 2007 2:53PM L_0 Inc. <br />01/29/2007 12:06 2094640138 <br />.. RREECENED <br />1400 757 07 p.2 <br />ENVIRONMENTAL HEALTH PAGE 01/01 <br />EHD LOG NUMBER <br />DATIE7A'WT9 2007 SAN JOAQUIN COUM <br />ENVMONN=nAL HEALTH DUARTMENT <br />ENVIRONMENT HEALTH 3io Eag WeberAvenue, Floor,Stockton,CA 95202-2708oE <br />PERMIT/SERVICE �dpho;t(2o)-iia-342o vex: (209) 464-0138Web: wRa4PV-0r/ehd <br />PTTRTJC RECORDS RELEASE APPLICATION _a n� J <br />APPLICANT: <br />ADDRESS: <br />PHONE(ix L40%`37-7 �� PHONE (1): q[� 543 15:421 FACWILE: �D$ �7i% 7177 <br />TENTATIVE• APPOMTMENT DATE: Txne: <br />. (Ploose allow to businom ess days Ndata of sppllation submIdd -•Tentative ONy-must be cow rmed) <br />CHECK BOX TU EXPEDITE REQUEST Q55.00 (CASH OR CHECK ONL)) • REQUEST PROCESSED IN 3 BUSINESS HAYS <br />SIGNATURE OF APPLICANT _ ifs DATE <br />Etoctronic Information: ❑ List ❑ Map Description: 1 r7 <br />FILE ADDRESS <br />EHD USE ONLY <br />p tUWgRa*oIRe Txw(USTI cLump SrrE(LOP) WNOasNzA"TDW0 <br />Seeet iM Sueet Name City <br />Unlit <br />KY <br />�ATERTREAwEMIPLANT <br />WCTRUGYIEMFT06 <br />IR MAZAR000SWASTE 0CMUTOR �i� <br />H vJ unit 2 <br />2. <br />S. <br />'41 LI3 <br />Urdt3 <br />a <br />5. <br />"'. <br />UnRe <br />6. <br />7. <br />unit s <br />8. <br />9. <br />Unit s <br />10. <br />Specific Date Rartge of Inromiation Requested: From Old_¢Si- ei <br />to ,6-u\,r, _S L <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />p tUWgRa*oIRe Txw(USTI cLump SrrE(LOP) WNOasNzA"TDW0 <br />��FI//L��ES <br />p9�5OtDWAaTE FACILrtVNHRCLE <br />¢ <br /><�R' <br />TMR CLU" arm 04ON-LOP) F i:900rAotnv <br />%YUGntORWaTAIK (MORITORRAtsMQYAL) T""KhNNELDA <br />�"OTA <br />KY <br />�ATERTREAwEMIPLANT <br />WCTRUGYIEMFT06 <br />IR MAZAR000SWASTE 0CMUTOR �i� <br />6 <br />W"'MPBMVIc' <br />0TATTODRCNe <br />Uta"Elknow <br />�$T= <br />�tAEDICALwA9iC FAGUTY 11"M(PLEAZE s PE�sT) <br />..... M •us.Mw- _ FYNAMNANNd►w. <br />1. List up to ten addresses In the space above. Select the type(s) of fit" from the Ust above by chocking the appropriate <br />box(es). At least one file type MUST be seceded. Fox to (201 g"138 or mail to the address Indlca/ed above Address <br />ranges will not be accepted—foraddItional assistance with Ale addresses, contact the EHD. Applications recelvec after <br />3A0 pm wiN be processed the next buslneas day. - <br />7. The EHD will notify the appllcMi If any EHD files exist An appointment for review will be confirmed approximately len (10) <br />days after racelpl of applicagon. The Ides will be held for a maximum of five business days for review. Appolntmeots <br />should be scheduled accordingly. <br />3. ABIe that is actively being worked on by EHD staff may not be Immediately ava0Ablo for ravtew. A new application maybe <br />submitisd when the Ilio Is available. <br />4. Any file 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 s f15Ao deposit prior to review.. <br />EHD USE ONLY <br />O <br />I <br />