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10/31/2005 10:50 51023332 APCADIS PAGE 01/01 <br /> 10/31/2005 09:19 4640138 ENvipotiv h AL HEALI,, ^! PAGE: 01 <br /> SAN JOAQM Com - - <br /> PeW E YIRO mFN Q.A.X.MALTH DEPARTMENT <br /> 304 East Webcr AYe ue, �' A, CA.95202-270t . <br /> Telephone:(2139)4G&3420 F :(209)46"139T <br /> (209)464-0138 b:wwwsjgvv.orcH <br /> PUBLIC RYCORDS RELEASE APPLICATION <br /> APPLJCMtT: rUSMr:, AGLNCY:, <br /> ADDRESS; O S� �^ <br /> TEKTAi= <br /> TP 'r,PPoth't DATE: -- <br /> 'find: 3 91 r <br /> (Pkase bow 14"In=W.from dtte of=ppG=aW tubtowuvw oray-must be cWMK <br /> BOX TO EXPEDITE REQU"T-$9 M Ftp(CASH OR CPMCK Ot Ly)—FZWe i Pt;(�M'N a f3USWESS sa47S <br /> SIGNATURE OF APPUCANT BATE; � <br /> {jfti 1 DtsTRtsVT D UcsR t o Unfit 2 Q Llrat 4 LhA E a watt c ❑ ower(a�ec6rolllofltsfshnalsQ} <br /> Fid ADDRESS AHD USE ONLY <br /> srt s strf tarn <br /> C <br /> 4. p rr / N�,� <br /> s. <br /> 7. U <br /> 9. - <br /> 10. i-L i 14. lltl <br /> Specific Date PWAQ of lnfQfTnation"Vested:prom to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILE$ y�. <br /> i3 SQM WAS=., <br /> TAtac(L<ST) (»i ❑H r sxn arr <br /> F�:'l 0 W,�TNTSnti(HoN-iAPI �lova <br /> Pt <br /> b <br /> 0 I�TAW-(iAP`i(T�R�Aca T3 DOG tSEfUSEi dA - <br /> tA <br /> E 9!{AzYVI st6 CsFrtE^nl�l ❑ � f3 1NASicAT1�J1iA( PT rttr <br /> 13P�..atrrad F ❑ o PU TM930Yl TouMa <br /> C TAsMQMB oyFTF.RCw QPvoIISFA i�LI1;DfJS�AOPt1CAi10N$ 1 <br /> Q x(mIpcALWAsTsfAcr,m ❑O; t(r'LEA4ESPRRFYy <br /> WQt_Alto fi@D'f� �'�' "ARE.�YARABL>i FOR R�Ytcw- IdON0A7�I�A1t Sr:49 M�'b'�� �7(OLVDRIC}#QLIDAYS,.. <br /> s of files from the list above by cheakiing the <br /> 1. List up to tan stddrasses to the spat®abouts, Seiecttl>atype( ) <br /> appropriatjo box(n), At least rine flee type MUST be so(ected- Fax o fZGS)a6,?�-Q138 or to the 2ddross <br /> jndicated above- Address ranges wHt not be a=apted—for addMonAl asl2istance with file addresses,oantact <br /> e,*E"D.ApplV-atiom received offer 3:00 pm Va be pr�-�d the next bossiness day: <br /> 2. The P-HD will notify the applicant if any E14D flies exist. An appointment fol•review will be confirmed <br /> sa,pprozimately ten(10)days after re*e1pt of application. The files will be held for a mazamum of fine business <br /> dans for review. Appointments chocstd be scheduied accordingly. <br /> 3. A file that is actively being worked on.by EHD tta f may not be immQdlatoty available for review. A neer <br /> application may be submitted when the file is available. EHD staff atthe exile a Of the <br /> +4. Arty file not retuned In the same condition IS released wjU be�r� ala by EHtprfor to review'. <br /> applicant. Future file rOviQuus by the same applicant may req <br /> �srwa <br />