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04/05/2006 16:59 13107982841 PAGE 02 <br /> b: E tlDo 12:45 46 ENVIRONNENTALO lH <br /> DATE RECERIECENEp PAVE 01 <br /> J <br /> SAN O AQurN CouNTX SHP LOG HVMatK <br /> � +NVIItONNTAL HEALTH DEPARTMENT <br /> 304 East Weber Aven=, 3rd Floor,Stockton,CA 95202-2708Z <br /> Fos; <br /> Telephone!(209)468-3420 (209)464-0138 Web; Www.sjgov.Crg/ehd <br /> q*74 <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> �,APPLI�At9Tl 'U n <br /> ADD RES6USI,N.E94a/'A,3,.E,NOyY: <br /> S ('�' cm NKI, M 1 ��' TA1£ <br /> PHONE{1kq 'yJ.F�3 (2): FACSRdIL,E ��-YJ S <br /> TENTATW AFFOINTMLNTDATE. - Time; <br /> (P14490 allow 10 business tlaye prom data of application m*mM.l-•nmienW only-count be coni mef!) <br /> CI CHECK BOX TO EXPEDrM RC T- FEE(CASH OR C 490K ONLY)-ReQUEST PROCESS=IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE S <br /> Elactronle ❑ List[7 <br /> IMdrmation Arap-DescADtlon <br /> FILE ADDRESS END USE ONLY <br /> strestR street Name CIS <br /> 1• <br /> 0 Unit 1 <br /> 4 CJ Unit <br /> 5'L5ftV- 1 A fnC7t ?MA L <br /> 7• ;eUnit 4 <br /> S. <br /> y, 7 Unit 5 <br /> 10. Unit 6 <br /> Specific Data Range Of llrfomfation Requested!From - to <br /> v ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> � UNOMMUND TANK(UST)CL6ANUPSfnl(LOP) ❑How= <br /> .�yM �gOL!C WA9TC FACR.TiYN4HICl.E <br /> /�OTNER CLEANUP srM(NON-LAP) ❑F000 FAgr6" ❑WA9 TIRE <br /> X UKO6RGROUND TAMC(MOMTomHorReIMAL) G DOG KRNNUL O DAIRY <br /> ';WHAZAnDOW WA97E OgN✓:RA.TCR 0Ci,C RANCH >CWAITMATFR TNEATMENT PLAerr <br /> ❑TMED PIRUMAO FACILrry 0 Mar"cTEL G PUMPER TRUCIUYARIVORGROCAL To!LET9 <br /> ❑TARCo1HOay Pimma M POWSPA ❑LANO USE APPLICATION SM <br /> O MSDIcA WAMFAMMY ❑OTM(PLEASESPEOIFY) <br /> Vft,ANO 9c"C PERKrr F=oK0*AAE AYAIIAImm roR REviow-MONDAY-FRIDAY 8:00 AM a:00FIA - EXCLuCMC HOLIOAM <br /> 1. List up to ten addresses in the space above, Select the type(e)of files from the list above by checking the <br /> appropftate box(es). At least one file type MUST be selected. tp(209)464 138 or mail to a addreE <br /> indated ebgve. Address ranges will not be accepted—for additional assistance with file addreaeas,contact <br /> the END.Applications received after 3:00 pm will be processed the next business day. <br /> 2. The END will notify the applicant if any END f(les exist. An appointment for review will be confirmed <br /> approximately ten(10)days after receipt of application. The file®will be held for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that It actively being worked on by EHD staff may not be immediately avallable for review. A new <br /> application may be submitted when the fila is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD ataff at the expense of the <br /> applicant. Future file reviews by the same applicant may require A$99.00 deposit prior to review. <br /> 040 Aha¢ <br />