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RPf i. '912 14:48 FROM:CRSSIDY'S JEWELRY 2094627111 T0:464me <br /> P.:3/3 <br /> DATE InM L.°' [unPl dea�uul vountY ne t177i11Dtr. IUMSER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> WOO- � 600 East Main St. Stockton, CA 95202-3029 <br /> Tole hone: (209) 468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd t <br /> 5 <br /> *1 -MIA <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT; (� � � � �( M BUSINESSIAGENCY; ��77 <br /> ADDRESS: civisTATEIZIP: 5i4KkI' C./7 ^ g Z/ <br /> PHONE (1): Zd —2601 PHONE(2): FACSIMILE, <br /> TENTRTlVE°APPOINTMENT DATE- Time: <br /> r-� (Pteato show 10 bus Iname days Tram date Orappircation sebmittal."Tenfa(fva onty.must be confirmed) <br /> L„t CHECK BOX TO EXPEDITE REQ T-$12 EE(CA CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE y- (p <br /> Electronic Information, ❑ List ❑ - eacr1p on: <br /> FILE ADDRESS EHD use ONLY <br /> Strout s Street Name city. <br /> Unit 1 <br /> �+ r S Szf � <br /> 7. w tiff[ fC�n S� . 5'�l 2 Urit2 <br /> s. <br /> A. <br /> Unit 9 <br /> 5. <br /> 8. tU <br /> UMt4 <br /> 7, <br /> 0. <br /> Dnit e <br /> 9. <br /> 10. 0 Unit a <br /> Spaclfic Date Range of Information Requested: From to <br /> may, ENVIRONMENTAL HEALTH DEPARTMENT Flt, n <br /> (9U1IGERGROUND YANK(LIST)CLEANUP SITE(LOP) ©HoosiNGARATEVENT tyT SVUOWASTEFACIt NE <br /> LR,,O'THERCLFANUP SnE(NON•LOP) C,]FOOD FACILITY L.J W&M TINE 2 �j l�fE/�,�/y� S <br /> rig WNOEfiGR0UN0 TANK(MONUORINe,,IfREMOVAt)p< E]Doc KENNEL ❑dAAiY ./ L„�'!( �� <br /> E?IWARDOUS WASTE GENERATOR L3(3 CHICKEN RANCH ❑WASTEWATFJt TRFA NT I <br /> I riefiED PERMITTED FACUN(?'— \ ❑MOT"OTEL ❑PUMPER TRu wARDYCHEMCAL TOILETS <br /> ❑TA1T0omoO7 PIERCWO ❑POOLISPA LAND USE APPLEArION&TES <br /> MEDICAL WASTE FACILITY ©CONPLAINTRECORDS 9DTHER(PL1ESESPEC(FY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REV I;w: MONDAY-FRmAY 8:00 AM-b:OoPM EXCLUDING HOLIDAYS) <br /> t. Lis ub to bn addrocss@ in the space above, Select the type[@)of files from the list above by checking the appropriate <br /> box(as): At least one lila typo MUST 17a selected. F to Tztlal asafit3¢of malt to the addreee Indlpgtet(4bove. Address <br /> ranges will not be accepted•for addldonal assistance with file addmaaes,contact Ba END, APPIIcsfiDna Tocelvod after <br /> 3:00 pm will be processed the next buslnese day. <br /> 2. The EMD will notify the applicant K any EHD files uxist. An appointment for review will be confirmed approAm■tefy ton(10) <br /> Clays after receipt of application. The thea will be netd for a maximum of five buslnesa days for reviow. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that Is doOVety being worked on by EHD staff may not be Immediately available for review, A new■pK�Catlorl may be <br /> sUbinitted when the Bio Is available, <br /> a_ Any file not returned in the Gams Condition as released will be reerganl2ad by EHD staff at the axpenae of the appilcartL <br /> Futuro file rovtewa h{Rha r is 5,7!71lonnt may require a$125 deposit poor to revtew. <br /> a <br /> -I 2 SSo- O <br /> 5 to F I Mord rpt Si 0 Fn.-ki ,sr . t <br />