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APR 06 '00 09:18AM ROUX ASSOCIATES INC P.2 ' <br /> DATE MEWED •�� � EHh LOCI NUMBER <br /> y SAN J=OAQUIN COU <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue,314 Floor, Stockton,CA 95202.-2708 <br /> Telephone: (209)468-3420 Fax: (209)464 I35 Web:www.sjgov.org/ehd IZ973 <br /> PUBLIC RECORDS RELEA E APPLICATION <br /> APPLICANT. .50-07L Go-4-. 1 6U8INR8WAGENCY: fO ' <br /> ADDRESS: ? a � [a7'LO�Cdr, filJ OIP e722 <br /> PHONE(1): v '" ` ^- ©C1 PHONE(21: FAc$IMtLE: <br /> TENTATIVE"APPOINTMENT DATE: Time; <br /> (Please elrow 10 business days from date of application submittal-•7iaetatfy9 only-must be confined) <br /> ❑ C#IECK Box To emDrre REQUE Ij$8.00 FE C C CIS ONLY)•REQUEST PROCESSED IN S BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE �Z-7--40(. <br /> UNIT DI$TRIBI,ITION CG Unit 1 IM UMI F Unit S ❑Unit 4 o Chit 5 M Unit 5 G Other(@lectronidltletslniaps? <br /> FILE ADDRESS EHD USE ONLY <br /> Street of 8tmet Name city <br /> 2. <br /> 3. t �� <br /> 4. �1, <br /> 5. <br /> 7. <br /> B. <br /> Specific Date Range of Information Requested:From to F)Q <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> HDERGRCUHD TANK(UST)CI:EANNP srrE(LOP) 13 Houaw A9Aimmew B$oL D WRsTE FAciLrTYn/EHICLE <br /> 1I07rQ'THOR CLEANUP SITE(Naw-LOP) 0 Fow FACILITY G WAsTe Tum <br /> .+5tlH r2R9ROUNDTANK(MONITORINOIREMOVAL) ❑Dm nNN& G DAM <br /> O HMARDOUS WAM GENERATOR ©Cffl=N RANCH 0 WASTRWATER TRPATMENT PLANT <br /> Ca TIERED PERNI'MFO FACILITY 13 AACTELMOML 0 PUMPERTRUCMARDICHEN TOILETS <br /> fl TATr BoorPiERCIN6 G POOLISPA 0 LAND UaEArPuCArioH SIrEs <br /> a NteaoAL WASTE FACUTY C3 O'rM@K(PLEASE SPECT <br /> MLL AND SsPnc PERMIT RScoRDs ARE AYAR.Ams voe Rgvmw- MoiiDAY�RIDAY&:Ori AM-5:08PN • EMUDINC HOLIDAY& <br /> t. List up to ten addresses in the apace above. Select the type( )of files from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected, ea_ D L4%:§j38 or mail to the addM <br /> jadjSgted above. Address ranges will not be acceptail—for additional asslstartea with file addresses,contact <br /> the EHD.Applications received after 3:00 pm will be processed the next business day, <br /> 2. The END will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately ten (40)days after receipt of application, The Oleo will be held for a maximum of five business <br /> days for review. Appointments should be scheduled a000rdingly. <br /> 3. A file that is actively being worked on by EHD staff may not b 1 0 immediately available for review. A new <br /> aFpl€oaWn may be submitted when the file is available. <br /> 4. Any Elis net returned in the same condition as released will b�reorganized by END staff at the expense of the <br /> applicant. Future file reviews by the same applicant may require a$98.00 deposit prior to review. <br /> M 4841AO <br /> 914% <br />