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s08- 1 11 <br /> � `_ 09-2006 <br /> 9252102467 ES Dept. ",j' ) EHD t_OG NUMBER <br /> ()ATE RECENED SAN JOAQUIN COUNTY' <br /> MCMVED EN MONMENTAL HEALTH DEPARTMENT <br /> 3{}4 East Weber Avenue,3 <br /> `�Floor Stockton CA 95202.-2708 <br /> AUG 0 9 2006 Teleghane:(209)468-3420 Fax:(209)464-0138 Web:www.sjFov.org/chd <br /> ENVIRONMENT HEAaH PUBLIC RECORDS RELEASE APPLICA'T'ION <br /> BUSINESSIAGEHCY <br /> APPLICANT:_-.Fd " <br /> ADDRESS: RQ 1—&J. w t/l <br /> a '— to—a�J�a FR.C>i�A6LE: <br />'r PHONE(1) PHONE PHONE(2): , <br /> TENTATIVE*ApPOHITHENT DATE: <br /> (Pease alloxr 10 brtalriess days from date of application submittal-'Terlfaa only-must be coniirmad) <br /> G, CHECK IpOX To EXF°E RITE RE.QUM•sss.00 FEE(CASH OR CHECK ONLY♦-REQUEST Ptt0CESSC0 1-4 3 BVSTNESS DAYS <br /> SIGNATURE CII APPLICANT. �_13A 'E <br /> UNri DISTRIOLMOFI 4 Untt 4 Unit 2 Unft 3 UaRs rullk 6 a other(elrtctronlolNststmaps) <br /> FILE ADDRESS EHD USE ONLY r <br />` stmtg Street Name' City <br />` S�C�.-D-3 S�- <br /> F _ <br />{ 4. - � <br /> 1a. — . <br /> - <br /> SpwiEic Date Range of Infom ition Requested:From _ f� — -- to -- <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> HOUl5rN6 ABATEMENT X fgxm WASTE FA ILrrymimcLE <br /> _W O F'ow FACILR Y: r-!ASM TIRE <br /> ' li I �1NiTGFJIREIE[ri'AI.) G DOO KENNEL AIRY <br /> GZARDWS WAFTE GENERATOR, ©CHICKEN RANCH `WAWrzjt1ATER-FREATMTX- r PLANT <br /> TIVrED PaUAMM FACRJTY D MoTEL1HOTEL L"PAtTRUCKffAMIG'H0111TOILETS <br /> TArrowwm'Piamwo- C1 POWSPA AND USE APPLICATM SFTFS. <br /> } IIIEDICAL WACTE FACILITY [3 OTHER(PLEASE SPECIFY)._ <br /> i WELL AFiD SEPTIarr <br /> C PVJ ¢r Rf:CGRD$ARE AVAILABLE FOR REVIEW- mo"oAY-FRIDAY 0:00 Atll^S:aOPif - ExMUDIM HOLIDAYS. <br /> I. List aep to tern addresses in the space above. Select the types)of flies froni the Uld Ebiaare.b-)!ch king the . <br /> approprifte box(es). lift least one file type MUST be selected. Fax to 1209)454-0x':38 oror mail to the to <br /> Iridic ed above. Address ranges will not be accepted.—for additional assistance with file aaddreases,contact <br /> a the END.Appitcations received after 3:00 pm will be processed the next business day. <br /> 2. The EHO wlil notify the applicant if any EHO files exist. An appointment for review will be confirmed <br /> f <br /> approximately ten(10)days after mc.elpt of appCication. The files will be held for a maximum of flvc business <br /> j bays for review. Appointsiments sh*uld be scheduled accordingly. <br /> i :L ,A fila that is actively being worked on by ENO staff may not be immediately availlable far rfrview. A new <br /> application may be submitted when the file is available. <br /> 4. Any file not returned In the sumo condition as released will be reorganized by EHD staff at the expense of the <br /> applicant` Future file raviews by tha same applicant may*ulre a$95.00 depostl prior to review. <br /> I i <br /> a <br /> �o ne-o-3 <br /> erlroa <br /> { <br /> i <br />