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Apr 05 07 03: 02p Kral n & Associates 916564 '^22 <br /> 02(0512004 12:12 46483 ENVIRONMENTAL HER 1-WoE P i2 <br /> env <br /> i <br /> I DA?��REI�ED - <br /> SAN JonQU1N COUNTY <br /> ENVIRONKENTAL JIEALTH AEPARTW NT <br /> 304 E Weber Ave 3r1 Floor Stockton,CA 9-joauinquin <br /> .ca.uslchd <br /> v ,I! t i' (209)46$-3420 Fax- (209)464-0136 Web:www-ee.santcl <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> Aj— V �G BUSWESSIAGENCY: <br /> PP <br /> A .LIGANT: iy ,l-�P <br /> yL ADDRESS: G/ -- ,j/ �Jf✓` s- <br /> /1f' PHONE: I FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> Nis SWOT <br /> -n (Please aaow to Dualnlss days PeRI date of aPali�Non avbmnWn <br /> HECK BOX TO EXPEDITE REQUEST-SDj7A E-REQUEST pROCESSED IN]BUSINESS DAYS <br /> c7 DATE IGNATURE OF APPLICANT _—��o DaPafenenl Uao Olay <br /> F40 <br /> FILF.ADDRESSw' <br /> : I,«. OUTh FP5%1�Vri' c IlGA:7C Unit 4 <br /> Vnm <br /> sal V <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> CILITY <br /> UNDF,RGROuxO YANK(UST)CLEANUP SITE(LOP) O FOODIFACIUTYGMENT ODM WADS,E V£H C E <br /> OTHER CLEANVP sn'fi(NON-LOA) p DOG KENNEL ❑ DAIRY <br /> UNDERGROUND TANK(MDNITORINGIREMOVAL) tl CHICKEN RANCH ❑ PKG TRFATet'.NT PLANT <br /> AZPRDOUS WPSTE Gtit4il OR ❑ MDTELIHOTPL ❑ UMPER 7AVCKlYARDfCHeM TDILET6 <br /> leftE0 PERMITTED FACILITY O PODUSPA No USE MPLICATON SITES <br /> [7 TAITOOInoDY PIERCING ❑ prHER(PLEASE SPEGFY) <br /> O MEDICAL=TLI FACILIYY <br /> 1• List Op to ten addresses in the space above. Select the type(s)of files from the list above by chocking <br /> the appropriate box(ce). At least one file type MUST be selected. Fax to(209)4e4013B or mail 1-0-W <br /> ddress indicated hove, tenant for review will be confirmed <br /> 2. EHD will notify the applicant k any EHD f les exist, An appoin <br /> approximatcty,five business days but no latae than ten(10)days after receipt of apptieatlon. The tiles <br /> will be held for a maximum Of five business days for review. Appointments should be Scheduled <br /> accordingly. <br /> 3* <br /> A Ala that Is actively being worked on by EHD staff may not be immediately available for review, neer <br /> application may be submitted when the file Is available. <br /> 4, Any file not returned In the same condition as released will be reorganized EHD staff at the expense <br /> . <br /> of the applicant. Future file reviews by the same applicant may require a$933.00 deposit prior to review• <br /> 5, <br /> *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> g• Applications received after 3:Do pm will be processed the next business day. <br /> TIME <br /> EREVIFVVFD <br /> MED APp01NTMENT DATE FAx f!1NfrrIAL-S <br /> PHONE <br /> FIRMED REVIEW DATE <br /> YES NO <br /> //3 U <br />