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06/20/2007 09:38 CLAY6 GROUP 4 12094640138 NO.858 5101 <br /> �.L <br /> DATE RE O EHD 1,00 NUMBER <br /> TUU( SAN JOAQUIN COUNTY <br /> ENMONMENTAL HEALTH DEPARTN ENT �� / <br /> ±EPIC!)j 304 Vast Weber Avenue, 3"e Floor,Stockton, CA 95202-2708 I <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjg0v-ol d <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 'Gk LGI BUSIN SlAGENCY: Ge CYI <br /> ADDRESS: �. O/( N ' C N <br /> PHONE(1); f1'f1.S)'9b PHON (2); FaCs[MILE; <br /> TENTATIVE'APPOINTMENT DATE; Time; <br /> please allow 10 business days from date of application submittal-•Tanlsllva only-must be ccanTmed) <br /> CHECK O0X TO FRPEOrrE REQUEST•S I=FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN s BUS11,15PE DAYS <br /> SIGNATURE OF APPLICANT t.- DATE 6 7c> D <br /> UNR OISTRIBl1110N O klfrl 0 Unit 2 56-11113 D Umt 4 O Unll s O Unll e D other(elecuanirniswimups) <br /> FILE ADDRESS EHD USE ONLY <br /> Street Street Name City <br /> 2. I <br /> 1 \O 1 3. <br /> \� 4. <br /> 7. <br /> s. <br /> 9. <br /> 10. 1 <br /> specific Date Range of Information Requested:From Al to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> :[INQE GROUND TANK(UST)CLEANUP SITE tLOP) D HOUSING ASATENENT 0 SOUL WASTE PM]UrYIv'4KMt.E <br /> V* RCLEaNUP8M(NON-LOP) toFom FACIUW 0WASTE TIRE <br /> RGROUNO TANK(MONITOWNWRWOVAQ 11DOG KENua ODAIRY <br /> A2ARneUS <br /> W=YE GENERATOR 0 CHICKEN RANCH Cl WASwwATEA TREATMENT PLANT <br /> TIERED PeRmMmo FACILITY OMOTeL/HOTFL 0 PUMPER TkUCA)YARDICHELI TOILETS <br /> D TArruolBoDy PIERG1Na; ❑POOUSPA d LANOUSEAPPDCATLONSREs <br /> O Meou;AL w&sTe FAcam D OTHER(PLEA9G SPECIFY) <br /> WE4 AND sePTC PERMR RECORDS ARE AyAIueL.E FDR RLIAEW• MONDAY-FRIDAY 8:00 AN`S;DOPM � FreLUCwO Ho Ys <br /> 1. List up to ten addresses in the space above. Select the typos)of files from the fist above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax to(2091464.0138 or mail to the address <br /> indicated above. Address ranges will not be accepted-for additional assistance with file addresses,contact <br /> the EHU.Applications received 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 appointmentfor review will he confirmed <br /> approximately ten (10)days after receipt of application. The files will be hold for a maximum of Five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A now <br /> application may be submitted when the rile 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 <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review, <br /> aN0 w-oaaac <br /> u1.ms <br />