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07/27/2006 08:12 FAX 19002/002 <br /> OAAMENV ED 10 <br /> SAN JOAQUIN COUNTY EHII LOG NUNW-13 <br /> JUL 2 7 2006 ENVIRONMENTAL HEALTH DEPARTMENT <br /> ENVIRONMENT HE#�KX East Weber Avenue, SdFlocr, Stockton, cA 9r)202-2708 <br /> PERMIT/SERVIC hone; (209)46&3420 Fax: (209)464-0138 Web: vrww.qgov.or9iefjd ��� <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICAN f: <br /> ., ._I4USflNESWA0FNGY:. XLaAJFJ�L< <br /> ADDRESS. <br /> PHONF,(2). <br /> TFNTATIVEft AWOINTMENT DATE <br /> —FACSIMILE. . 4L_(1.0 <br /> (Please all Orr 10 bus illes S d ays from_6)L2j0_(P — Timej.stic, <br /> in dato.ill jp�fluatlon stilimitlaf rru'0 6e_cvnfif7;�d) <br /> El CHUCK F3OXTOFXPED1lLRF.OVEt,'1 -693.UUFEE(GASB r,)RCHLCKONLY).RFCIUE.:SI PROCrgSEt)IN38VSINEF,,13D/kYl; <br /> SIGNATURE OF APPLICANT <br /> DATE _7,/47/& <br /> Tt4l T 013TRIRUI KV-1-- 6'­ii���.. <br /> 112 �J.11 4 ❑C3�6.,t 5 6"',8 <br /> ullil I a�9�j <br /> Other <br /> ELI�12 ADDRESS <br /> EHO USE ONLY <br /> -4- Simlif Nims 1City <br /> 7? <br /> (%A VJ%JPQF <br /> 3. <br /> 4 <br /> 04 <br /> -4. <br /> Specific Data Range of Inforilation RKIliestod: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> TANK(UST)Cl rANUPSITL(I OP) Cl I 101,151m',AlFATM17M 801.10WASTro <br /> s,Tt(NON LOP) 13 FOOD FACILITY <br /> AUNDFR(,'4R(.XJN0 IANK(Mf)NrT0RiW;lkcMOVA0 Rmw TiRF. <br /> IFNERATOR GkUGKFN RANCI I <br /> A�Ajax)tj�,Vftilf;0 Dno Kt:mn AIRY <br /> 0 [lEAEL) NLl1TtroPA(.l!lTY &�WA;;lLWAlF.qTwArf&NjPLANT <br /> n TA t7n0lROF1Y Pj[:Rt:lNl; ❑ <br /> MI)TL014011:L M- PU?,IP,�RTRut:KtYAP'I.WC�f�,.mTt)itFT'4 <br /> CI MENCAL WA�11, ITT F'CKJLI&'A 91�CAND Usl APPLl(:AlinN$1-,r_s <br /> M OTHER(PixAst:spr <br /> WF(I.ANnSrPTJCPLRkilIRt-.(;(Mn^t,RLAVAii.Agl.hP(,)RRrvir:w- M0N1lAVTll10AYli:00AM-5;00Fm EX01 QVINC,1fULlDnYS. <br /> Y. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the <br /> appropriate bOX(es). At least one file type MUST be selected. Eax to (209 464.0138 or mail IcLthe ad res <br /> cL <br /> indicatpdabove. Address ranges will not be accepted-for additional assistance with file addresses,contact <br /> the EHD.Applications received after 3:00 pm will be processed the next business day. <br /> 2. Tho EFID will notify the applicant if any EHO files exist. An appointment for review will be confirmed <br /> approximately ten (10)days after reocipt of application The files will be field for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that is actively being worked at, 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 593.00 deposit prior to review. <br /> r.Fin 41.l VV W, <br />