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05/03/2005 11:34 209-579-7MODESTO ATC PAGE 02 <br /> IF go <br /> DATE RECEIVED EHD LOG NUMBER <br /> SANJongvnv CaurrrY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> Z351 304 East Webcr Avenue, 3i4 kloor,Stockton,CA 95202-2708 <br /> 'Telephone: (209)468-3420 Fax:(209)464-0138 Web: www.sjpv.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICA'T'ION <br /> APPLICANT: rt�!! �, BUSiNESSIAGENCY:A'rCJi f.': <br /> ADDRESS: BAtm- 64ee= 1 � �iTLA Ga <br /> PHONE(1):1�.�.��• 17.11 PHONE(2): FACSIMILE: Zdl Cis". <br /> TENTATIVE'APPOINTMENT DATE: 5'l�•O(� T''M:�AA� <br /> (Ploass alias 10 business days from date of application submlthl-"Tnrtaflra only.must be conflrmeTI) <br /> CHECK BOX TO EXPE°�R`����0000����tttt)E/r��7)((1I193.00 FEE(CASH OR CHECK ONLY-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURI"OF APPLICAfdT' S� 110`. DATE c�•��S-� y�__ <br /> UNIT OISTRIBUTiON 0 U.41 0 Unit 2 zeUnd 7 AUntt 4 0 Unit 6 Una 6 0 Olhsr(aloctronlcAItt&maps) <br /> FILE ADDRESS EHD USE ONLY <br /> nes,t R stress Naos City <br /> 1. `( E. va'r C *VL <br /> 2. 10 w ii T <br /> 4. <br /> 5. C-T . <br /> S. <br /> 7. <br /> 8. <br /> 10. <br /> specific Dato Range of Information Requested:From fA'ST to <br /> ,y, ENVIRONMENTAL HEALTH DEPARTMENT'FILES <br /> AUNDERORW NDTAw(UST)CLEANUP arm(LOP) 0 HDusING AaAT mce IttionJo WAT. F.ALTLrryNEMICLE <br /> Om1ER CLEANUP SeTE(NOW-LOP) 0 FOOD fAcR 0 WASTE TIRE <br /> UNDERGROUND TAW(MON[TORMGMUFMOVAL) 0 coo KENNEL O DAIRY <br /> HAZARDOUS WASTE GENERATOR M CMICIaN RANCH GT WASTEWATER TREATMENT PLANI <br /> 315TIEREO PERMITTED FAC%JTr 0MOTELrHOTEL O PU14nK TR9CKNARDfCHEM TOR.ET3 <br /> 0 TArrooMD0YFIERCINO 0 POOLISPA 13 LAND UTE APPLICATION SITES <br /> It MEDICAL WAate:FAGRRY ❑OTNER(PIFAsa srza ) <br /> WELLAND SEP PEKWT RECORDS ARE AVJULARLE FOR REVIEW- MONDAY-I'MAY 6:oD AMS:OWM . EXCLUDING MOL®AYE. <br /> 1. List up to tan addresses In the space above. Select the type(s)of files from the Hat above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax to(208)464-0138 or mail to the address <br /> Indicated above. Address ranges will not be accepted—for additional assistance with file addree*es,contact <br /> the EHD.Applications roceived after 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximalmly,ten (10)days after receipt of application. The files will be held for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A fila that 19 actively being worked on by EHD staff may not be Immediately available for revieww. A now <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 by EHD staff st the expense of the <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> END ua2aa <br /> 1114m: <br />