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z <br /> 5252102487 E5 Dept. - 11:7a_m. 08-09-2006 111 <br /> (�DATE((RECECAD � - EHD[(OG NUMBER <br /> SAN JOAQUIN COUNT <br /> !!�!E LCA E i V E 0 EI -VIRONMENTAL HEALTH-DE YPAR 1�kT <br />� � EI�T <br /> 304 East Weber Avenue,3 Floor; Stockton,CA 95202-2708 <br /> AUG Q 9 2006 Telepb�one:(209)468-3420 Fag:(209)464-0138 Web:www.sjgov.org/chd <br /> ElVVi QBE ENTHE <br /> tSEN Q <br /> P3J PUBLIC RECORDS RELEASE APPLICATION <br /> _ <br /> APPLICANT:Z'(_ BUS1NESSIAGENCY:,Z6Z(,-11- Cx)-A <br /> ADDRESS: � N. (' l C: e <br /> PHONE(1).-& `o (0`�w��� PHfJNE(2): F,R.C$I19ILE: <br /> TEhITATIYE"APPOINT11Eorr DATE: 1111 ~Ps+�`a�� ���' , Tlfi,•: ` <br /> (Pimaue allow 10 business days from date of apPlfcation submittal-°TentaNw only-must be contirmi�d) <br /> CHECK DOX TO EXPEDrrE R QUM•;9-5.00 FEE(CASH OR'CHECK ONLY)-REQUEST PROCESSED 1!4 3:BUSINESS GAYS <br /> 81WIATURE O APPLICANT ^ �� �; .__..•. .•_ DA"1"E <br /> EU�1ri'DISTRIiaUT18Pl L7 Un1t 1 E!n[t Z Unil3 A UDIt 3 Unit 8 A Other.(elllctronlclilstslrnaps) <br /> FILE ADMESS EHD USE ONLY <br /> _ sweet s £first Name' City <br /> F2. ----- <br /> - g <br /> 5: <br /> 7. <br /> 1Q�� <br /> Specific Date Range of Infomiation Requested:From <br /> ENVIRONMENTIO.HEALTH DEPARTMENT FILES <br /> 1 E3 HoLowmG ASATEmEwr Soup WASTE?FACILIrYMHICLE <br /> 17 FOOD FACILITY iilASTRE 17RIE <br /> C ONITOFIIIWREgCCIM4 ❑Doo KewEI rl nAtRy <br /> WARDOus WASTE:GCNBRATOR 0 CHICKEN RANCH J13TicA'ATER TREAntE:NP PLva <br /> TIERED PIMWgrT rFI1 FACILITY i?11TOTELIHOTEL Pot TRUCKjrYAF,CICHFM TOILETS <br /> }TATroafflow Prctt cmo 17 POOLISPA AND UseAPPLICATPM SnES . <br /> �C 7 11Eo1CAL WArm F'AGILrTY 17 OTHER(PLEME SPECIFY — <br /> t_ WELL Alan Sorm Pp.RurT Rfmows A,,m AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-6;004r, • EXCLUVOK;HOLIDAYS. <br /> 1. LIMt yup to teri addressos in tl1e spaceabove. Select the type(s)of flies from the loth above.ty checking the.� <br /> appropriate box(es). A► laasl one file"MUST be selected. Fax to f20914�s4-0-138 or mall to the to <br /> Indeed above.I Address ranges will not be accepted—for additional assistance with file addresses,contact <br /> the EHD.Applications received aftr 3:00 pm will be processed the next business day. <br /> 2. The EHD wlil notify the applicant ff any EHD files exist. An appointment for re0re will be confirrned <br /> approximatoly ten(10)days after mceipt of application. The files will be held foro maximum of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A files that Is actively boing worked on by EHD staff may not be Irnmediatety available for mAmr. Anew <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$95.00 deposit prior to review. . <br /> i <br /> _ e <br /> ereoasol � � <br /> WIN i <br /> t <br /> I <br />