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04/05/2006 16:59 13107982841 PAGE 02 <br /> eal0I/2006 12:45 4641g, ENVIRONPENT.4L IH PAGE 01 <br /> OA7E RECENMO ENO LOG NVMtrcR <br /> SArr,ToAQ>im�i COUNTY <br /> EwmoNtEN TAL HEALTH AEPAR.TmENT '��� <br /> 304 East Weber Avenue, 3'4 Floor,Stockton,CA 95202-2708 <br /> 60 Telepbone:(209)468-3420 Fax:(209)464-0138 Wcb: www.sjgov.erg/ehd <br /> 4 <br /> . I -' I"ill <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> iDAPP1,lj AVT;- <br /> n _ 9U91NEas/A,6,.E�NyCY:^. �. <br /> ADDRESS: <br /> PHONE 1A&(21: FACSiMIL 3 1 <br /> TENTATIVE'APPOINTMENT DATE. � rim el <br /> (Plaasa 21T=10 business days from data orapplicadon OobRliaal--rimtnhm onty-must be cc4dirmed) <br /> ❑ CHECK Box m EXPEorm RF 7- FEE(CASH OR CHECK ONLY)-AeQUEST FROCESSED IN 3 BUSW=DAYS <br /> "SIGNATURE OF APPLICANT DATE <br /> Eleefronle ❑ List O De=d <br /> IMOrmatlon �P- pgbn <br /> 1715 1 SS END USE ONLY <br /> Strast of stmat Name city <br /> 1 ❑ Unix 1 <br /> 3. a11 Unit 2 <br /> 4. I r <br /> s- 0 Unit 3 <br /> is Unit 4 <br /> s. <br /> y 0 Unit 5 <br /> 10 Unit 6 <br /> specific Date Range of Information Requestedt From m <br /> y ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> CLINDERGROURD TANK(UST)CLamup 9na(LDP) r7 HOU9n;AaAT6MENT .11 §%m wAM FAQUIYfV2M Al <br /> Oq OTHEP CUCANVP STM NOW-LOP) ❑FOOD FAG0.nY ❑MrAxni nsm <br /> R UNDERGROUND TANK(MoNm ih wrReuovAl.i ❑DDG KRNML O DAIRY <br /> WHALmmUG WASTE OENEPATOR 004oxmRANO" XWAETEWATER TRpATMENT PLANY <br /> ❑TtRRED PERM TTEO FAOILITY d Mam.!HOTEL 0 PUMPER TRUCKIYARO/QNEMICAL TOILETS <br /> ❑TATTOOMIODT PIER"O M PDw.lSPA ❑LANb UsK APPLICAnDN am <br /> ❑110wc WAMFArauw ❑ 0T10R(PLEA9E3P=1-Y1 <br /> w1nL AND 86PTIC PERMIT Rwc ba ARE AYAnAKL FOR RE RW -MONOAY-FRioAY 0:00 AM-5:00PM - EXCLUDING HOLmAm <br /> 1- List up to ten addresses in the space above. Select the type(s)of files from the fist above by checking the <br /> appropriate box(es). At least one file type MUST be selected- Fax ta[ZO9)48A.0138 or mail to ft address <br /> lndicated a ye. Address ranges well not be accepted—for additional assU t tics with file aadresSas,contact <br /> the END.Applications received alfter3:00 pm will be processed the next business day. <br /> 2. The END will notify the applicant if any END fifes exist. An appointmant for inview will be confirmed <br /> approximately ten(10)days after receipt of application. The files will be held for a max-MUM of five business <br /> days for review, Appointments should be scheduled accordingly. <br /> 3. A file that is actively being worked an by EHD staff may not be immediately available for review. A new <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 review. <br /> WDA4A <br />