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4649130 • <br /> �F'7�'-"�"`1'•-f+ _ ;� ENVIRONMENTAL HEALTH <br /> )r �IAN.TOAQUINMUN'TY PAGE 01 <br /> Y-NV RoM ENTAL REALM DEPARTMENT <br /> iy 3 2003 T 304 East Weber Avenue, P Floor, Stockton,CA 95202.2708�� (� <br /> it ',i?h CIVIRO so:(209)468-;3420 Fax: (209)464-0138 Web., www.sjgov,orpJoh / <br /> 2. <br /> r;"''r �"� "Ce77`''PUBLIC RECORDS RELEASE APPLICAUON <br /> APPLICANT. 0101 <br /> �L� �����(�[ EU5WES5fAS3ENCY:' 1 CON u(Y.rR N i,5 . - <br /> ADDRESS: t�C? � t I YL I O. I. _ [� �t¢ <br /> PHONE(1): Y'f'-� Pf10r1E(2)I FACSIMILE: 2• <br /> TENTATIVE'APPOINTMENT DATE;_ I �/6g Tima; I I �X30 A�vl <br /> (Please allow 10 business days worn dale of apphiE submlurl--rWtative only-must be con lrmed) <br /> ❑ CHECK BOX To EXPEDITE REQU $9S (CASH OR CHECK ONL))•REQUEST PROCrrSSEO IN 3 BUSIRMS GAYS <br /> SIGNATURE OF APPLICANT DATE o r-- <br /> Electronic Information: ❑List❑Map—Deacripflon- <br /> FILE AODRP_SS EHD USE ONLY <br /> _" 9traot# Street Nama City M6Z-'. l al .d E$C Unit i <br /> a� 1. I IA)lS�(A7Ll(7W' �OGKhsv� �J }� C' <br /> 2. LIC iTSF ) <br /> unitx <br /> 3. <br /> 4- Unita <br /> 5 \0/t)nit d <br /> S Cl Units <br /> S. <br /> Unit 6 <br /> Mill <br /> Specific Data Range of Information Reyuesisd:From {o / <br /> �,'11/ , E'NVIRONM'ENTAL HEALTH DEPARTMENT FIIL% <br /> wt=GROVND TANK(UST)CLEANUP Srm(LOP) ❑HOUaWGABATFNENT IZZOLID WASTE FACIUTYNENICLE NIL//d" <br /> ISHI�JHEA CLEANUP SnE(NON•LO)') MFWD FACILITY 1.-TA.,=TRE <br /> W-TINDEWROUNDTANK(MOIIITORINOIREMOYAL)ve O DOD KENNEL Ta DAIRY <br /> pOVS WASTE GFNERATOR J Ct CNICKEN RANCH MAYMMWATER iRLATHFNT PLANT <br /> - <br /> PERNn7CDFACILITY✓ Q MOTELIHOTEL M PUMPER7RU0N1YARDICN3MT0UMG <br /> ©TAY00/8ODY PIeROINO 13 POOUSPA 0,LAND USE APPLICATION SITES <br /> 0 MPOICAL WASTE FACILITY C3 OTHFg(PLEASE SPEWPY) <br /> WF.LLANDSEPTIOPERAUYReO0kp$ARCAVALABLE50RREVJEW* MUNaAY.FRwAYI3:o6 AM-S:OOPM - EXCLUDDrQ MDAYS. <br /> 1. Llst up to ton addresses In the space above, Select the types)of flies from the)1st above by checking the appropriate <br /> box(es). At least ono file type NIUET be seiectod. Fex to 12091 A64-013a or mail to this address Indicated above. Address <br /> ranges will not be accepted-for addlflonal assistance with file addresses,contact the EHD.Applications received after <br /> 3:00 pre will be processed the next business day. <br /> 2. The EHD will noefythe applicant if any tEkD f'los exist. An appointment for review will be confirmed approximatelyten(10) <br /> days after receipt of application. The Tilos will be held for a maximum of five business days for review. Appointments <br /> 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 now application may be <br /> submitted when the file is available. '1 <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 a$98.00 deposit prior to review.. <br /> EHD USE ONLY <br /> r}m4.5 to=o <br /> TO 39tid Tb8Z86LOT£T LT :9T 899E/£O/19 <br />