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05/12/2015 10:59 2098330707 !��.��.//� D UPS STIIRE1860 PAGE 01/b1 <br /> rf,�• (�_"J�+� EHD.LOG NUMBER <br /> D TE RECEIVEb A1Ut COUNTY <br /> MAY 12 2015 ENVIRONMENTAL HE TH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 F <br /> SVVIRON ENTALi-iEgEPIephone: (209)468-3420 Fax: (209)464-0138 Web: wWw.sjgov.orglehd <br /> FERMI T ISERV'sCES <br /> PUBLIC RECORDS RELEASE APPLICATION 1 r <br /> APPLICANT: �J Sd� BUSINESSIAGENCY: ��'wnt� GYV tr- <br /> ADDRESS: SI Yh I fA�fQ{ ls� CITYISTATEIZIP: l�ouLo"L rI12,-l'6-i ' 6 <br /> PHONE (1): k?1-762,—kR_,C9 PHONE (2): FACSIMILE: <br /> Please allow 10 business days from date of application submittal for the records to be available. <br /> Staff will contact you to arrange an appointment date and time to review thArequested records. <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$125 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List ❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street B Street Name city ❑Unit 1 <br /> 1. e�1- T!a >; <br />