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�. 03/25/2005 15:01 <br /> 15:01 209795 APERID INC � PAGE 02/0 <br /> In J 51`x' SAN JOAQUN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> "�' 9. 37005 304 East Weber Avenue, 3`4 Floor,Stockton,CA 95202-2708 <br /> ENVIRONMENT HEALTH <br /> Telephone:(209)468-3420 Fax:(209)46"139 Web--www.sjgoy.or(*/ehd <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: � al�Y\e. �y(S BUSKIN:&S�AGENCY:,.,,,�.�T �r� <br /> AOORMSS: �y p <br /> PHONE(tk ~I-LS -IJ~.�5� PMNE(2): FACSIMILB: '2.L) 3 <br /> q <br /> TENTATIM APPOINT1fSHT DATE._ lin r v ($��.�Q •-rte•: <br /> (Please gnaw 10 Gasltwss days from data appagtlon solanll>al.•Tsmeaws omy-mea!he conA }.. r;�3AR 2�8 24 <br /> E3 CHECK BOX TO WVWrrE REQUEST-$93ho FEE(CASH oR CHECK ONLY)-REQuVST PROCES4E0 W a 13491046S-DAY.9 <br /> SIGNATURE OF APPLICANT ^ DATE _ 3"ZS <br /> UNii DI&TRn3UT10N M UM t k 5 Udn 4 0 Una l Unit e P Oster(ataatraniGGaWInaP�) <br /> F1LLa ADDIXESS ChY EHD USE ONLY <br /> F* street Hama <br /> a5 ovcG lt1-0 rt <br /> 4. <br /> C <br /> U� <br /> S Hw <br /> 6.J <br /> X11 <br /> t <br /> J OGIL <br /> rt <br /> E t> c <br /> 7. <br /> Spedfla Dato(longe of Information Requested:From >'a d to `S <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNXM4*WK0TAW(UST)CaMU►801(LOP) 0HOUSMAnanMMA' S0LWWxsTEFA=ffdV4= <br /> ji(QnIENCtLVW 80E(NON-40M E3F000 FncWy WASTEMNE <br /> )(A7)V= a WAIITE GEMM7M ❑cHomN Rwwm pWA�TEwnTOMTUAYrarrPuwr <br /> 1-1 TmepM psapn4u FAon.w O r4OTEl/NOTFA- pyyrEN7wcxll'ANdtltrrl TdIFTs <br /> 0 TATT001VO w Pu lMW 13 PooLISrA A I"Use Arn]CAMN Snrs <br /> Q IAF `-.LL Se:.:IGa'l'-�.._�• ❑�1T:�fiR(PlKJ1�l ►dCMY)._.:__ <br /> WY AND 5UM PMKT RK:0* u r-AVM-AaLl FON roweN- MONDAY-FWAY 11:00 AM-b:OPRM - Fv..._n�x,iur:HptnAYs. <br /> —c6j <br /> 1. List up to ten addresses in the spate above. Select the type(a)of files trom the Ilat above by Checking the <br /> Appropriate box(es). At least one file type MUST be selected- Fax to( 8146 mail to the adder <br /> indicated a M Address ranges will not be accepted—tor Additlonal assistance with file addret:eee,contact <br /> the EHD.Applications mcsived after 3:00 pm will be processed the next business day. <br /> 7. The CHO will notity the appl4;amt it any E.ND flee exist An appointment for review will be confirmed <br /> approximately ten(10)days atter receipt of application. The fila will be hold for a maximum of live business <br /> days for review. Appointment$should be scheduled accordingly. <br /> 7. A file that is actively being worked on by EHD staff may not be immediately Available for reviow. A now <br /> application may be submitted when the file w evaliabie. <br /> 4. Any file not retamod in the same condition as released will toe reorganized by EHD staff at the expense of the <br /> applicant. Future file reviews by the same applicant wary require a$93.00 deposit prior to review. <br /> rxo 4aaxcae <br /> ,n �o:-,� ui-x,�u ntiinrn.min�Tnhia RFi0b917 40�5t S00L19LiE0 <br />