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07/14/2008 14:35 CLAYT` PLEASANTON 4 12094640138 NO.1354 D001 <br /> - , 0/ SAN JOAQUIN COUNTY F-HO LOG NUMBER <br /> $, ENMONM>ENTAL HEALTH <br /> DLPACRA 9 -T2 <br /> 708304 East Weber Avenue,3dFloo ,Stockton, 5202 <br /> Web:www.sjgoy.or /Teteptwna:(209)468-3420 Rax:(249)464-Oi38H g _ <br /> PUBLIC RECORDS RELEASE APPUCA.'TION <br /> APPUCANT.-Awsvr, okh(.( tdUSINESSlaGl lcY:47�yc +�V�r1'>h�f <br /> ADDRESSU110 V441 IUl'�1>V1ZL S/ <br /> PHONE{tMPHONE{1h. rte' Y"'f i FAGSUIitf GJ `�AIZLQ i�)ble <br /> TENTATlVF-*APF'0wTuEwT oA7E I a D Tone: <br /> (Ploano aaow is businem days frau dab of application submivai-Tentative only-mutat be confirmed) <br /> d CREEK BOX TO EXPEDITE REQUEST-MOD FEE(CASH OR CHECK ONLY)-MWEST PROCESSED IN 3 SUSINESS DAYS <br /> SIGNATURE OF APPLICANTDATE f 6� <br /> UNIT DISTi 8LrnoN O Unit 1 0 Unk 2 O Utas 3 0 UnE 4 0 Unit S Unit 5 0 i5titer(eiec(>npiCfih %1 <br /> FILE ADDRE=SS I <br /> EHD USE ONLY <br /> Stan# Street Nance city <br /> i 1Its- <br /> 2. i qfr I <br /> 3. rill I f I l <br /> 4. t7 rd; <br /> `6. ��• <br /> s• e I <br /> 7• f I <br /> 110. 1 1I <br /> Specific Date Range of Infomiation Requested:From to (: <br /> ENVIRONMENTAL HEALTH DEPARTUENT FILES <br /> fo== <br /> uNo TANK M CL"M r Stye(LOP) O House AaA'twurr Sam WMTE <br /> CLEANUP&M(NON4.om 0o FACa.trY wABre TIRis <br /> 0ROLllIDTANK(o10�aToaNGrFtEliovALy OOools3 DAIRY <br /> O� PEM WA FORMP rM CMCKJMRA >.0WASnWAMTMATNetTPLANT <br /> PUYPmT>:tj=NARN*cm . <br /> TATTDOIBODY ANO WODLISPA Ai,/Vif7 USS APPLICATION$M <br /> 6DlCAL wASM FACS M U OTS ftAASR S <br /> WELL AND SEP=PMT NEC.ORna ARE JtVML*ZLE FOR REVIEW- MMNMy-FRmAY B_aa AY,5:CDM -FXGLLUW HMMY& <br /> 1. Ust up to ten addresses in the space above. Select the WON)of files from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax to(2091464-0138 or mail to the add ss <br /> indicated above. Address ranges will not be accepted—for additional assistance with file addresses,contact <br /> the END.Applications received after 3:00 prn will be processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately ten(14)days after receipt of application. The files wilt be held for a maximum of five business <br /> days for review. Appointments Should be scheduled accordingly, <br /> 3. A fife that is actively being worked on by EHD staff may not be immediately available for review, A neer j <br /> application may be submitted when the file 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 raviewr. <br /> Vii^ i <br /> . �l046am00r <br /> 4h Noe <br />