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DATE RECWVM <br /> (c SAN JOAQUM COUNTY EHD LOG NUMBER <br /> I (�` E� J I CI V-WMONX9NTA)(x HEALTH DEPARTMENT <br /> U Ll V L 304 E Weber Avc 3r4 Floor Stockton,CA 95205 <br /> 9)468-3420 Vsx: (209)4 ' u)n.ca us/ehd I <br /> DEC 10 <br /> 2 � 64-0138 Web:wWw.co.san-�°� <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> EN I F ^ <br /> BUSINESSIAOENCY: <br /> ADDRESS: Sri SL. '�. �.�fpq <br /> PHONE: 209- C47-(oyc. FACSIMILE: n <br /> TENTATIVE*APPOINTMENT DATE:�2- 2 (- a.�.- <br /> (Pleaea 8110W 10 bu4lnes0 days from dab of application submittaii <br /> 13 CHECK BOX TO EXPEDITE REQUEST-$93.00 FEE-REQUEST PROCESSED INS BUSINESS GAYS <br /> SIGNATURE OF APPLICANT DATE 112 <br /> Deparbnent Use Only <br /> FILE ADDRESSUNIT <br /> USS;r <br /> Oki I, sv=a S i. Hi4w-y 19 C Il1an}tca_ <br /> z se..+ A �nca `,� r. ❑ Unit 1 qq'� <br /> a. sred G awe Q Unit <br /> _ n sws <br /> fUn <br /> it 4 <br /> 77 2 9. SYea <br /> Io. sww <br /> 2001 ❑ Unit 5 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES d <br /> er-UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING A13AYEMENT 0 SOLID WASTE FACILITY 1 <br /> W'OTHER CLEANUP SITE(NOWLOP) ❑ FOOD FACILITY M SOLID WASTE VEHICLE _ <br /> ®''UNDERGROUND TANK(MONtTORINGIREMOVAL) 0 DOG KENNEL ❑ DAIRY <br /> IT HAZARDOUS WASTE GENERATOR b CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY 4 NOTELINOTEL E2 PUMPER TR-UCKIYARDK:HEM TOILETS <br /> 0 TATfOWBODY PIERCING 0 POOLISPA ❑ LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> 1. List up to ten addresses in the space above. Select the type(s)of flies from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(209)4640138 or mail to the <br /> address indicated above. <br /> 2. EHD will notify the applicant If any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10)days after receipt of application. The files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new <br /> application may be submitted when the file Is available, <br /> C Any file not returned in the same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> 5. *TENTATIVE appointment dates must be confirmed with EHD staff. <br /> S. Applications received after 8:00 pm Will he processed the next business day. <br /> r: :;Cal .�cu.:;FJ•k, s?n,n,Ca:Fr;r' ,.,;�..: u;i'�lillls.o-;��3is <br /> t�"�, t .t° r ;ki."(-Pi , xfael.°i w 'aa T n rw,;Y�.�r,,!'11u rr� a i �'VY.��'.]`rtiyM iya-.. ..°uR1u wm�t.�r'IA4<i°(r y�al� ll ♦'L <br /> S, ! � > .�ci��i i 4 " �:;i,"�' +�°��� Y=� "ff'.��'Ye rva r.u^'C�7�e4�af�'� �,� i' y�ai)':•' <br /> � l� ,. :,..,� »461,e Q.�,, A�r�!.�....���'�r„�:hPP,IK .��1.61�51, ���•.. .ui un y,... Yi:.1Y;,!�,a <br /> ew/aaxoos <br /> uamw <br /> 0/T0 39vd NODOO.LS 39V 8TITL906OZ 9E:01 4002/0T/Z1 <br />