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-DEC. 13. 2005 1 , 03PM ODOR EnRTH TECH `` O, 4112 ' 2 <br /> 1 C ^ , i 1f i NUMBERA <br /> p CEIYEOSAN JOA4 COUNTY �� /0.'ftF <br /> F I ENVIRONMENTAL HEALTH DEPARTMENT � �. <br /> APPLICANT: <br /> �' '� `�F�� 304 East NVeber Avenue, 31d Floor, Stockton, CA 95202-270$ <br /> �4VIi U1#i,i'cf i HLA )}cphome:(209)468-3420 F2x: (209)464-0138 Web. www.sjgov.org/ehd <br /> 'ER riIT�",r VICE PUBLIC RECORDS RELEASE APPLICATION <br /> BUSINESSfAGENCY: apm <br /> Z -pSl '2G4 FACSIMILE: ?S8 <br /> PHONE(1): PsioN�{z}: + <br /> TENTATIVE'APPOINTMENT OATS: Time: <br /> (Please atlaw 40 business days from date pp on submittal-*Tentafrve Holy-must be confirmed) <br /> CHECK BOX TO Di E UEST-5'53.00 _E A CK ONLY)-P QUEST PROCESSED;N 3 B SI <br /> SIGNATURE OF APPLI DATE <br /> UNlTDiSYRIBUTION a U 1 d Unit2 R Urtr Q Unit i�Unit5 C7 Unit Qther(elactronic!listslmaps) <br /> FILE ADDRESS EHD USE aAPWA. An. <br /> N Y <br /> 5Veet# Suet Namedlr <br /> a. . <br /> 3. WL <br /> 4. <br /> 6. <br /> i. <br /> 8. <br /> 9. <br /> 10. <br /> Specific Date Range of Information Requestsd:Front <br /> ic�TmER <br /> ENVIRONMENTAL.HEALTH DEPARTMENT ,,�y�ES <br /> OGRGROUND TANK(USTo CLEANUP SITE(LOP) b'<o6_3fNG AaATFMEW, �ouD WA97E FACILITYNEHI LE CLEANUP srm(ANON-LOP) 0 FOOD FAcury TE TIRE <br /> ERGROUND TANKf�[MONrrOFUHGM;eMOVAL) 13 DOG KPNn£L ,�,(pAJRY <br /> ��E HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH 92 riASTEWATERTREATME.NT PLANT <br /> C�MOTaMOTEL ❑1 PU PER TRticK1YARDfCHex:TOLL-Ts <br /> TIRED TAT-rooffloDPERmPIE FACILITY 0 POOLISPA ti-rAND USE A"UCASION SITES <br /> d MMICA1,WAST FACS G ❑OTNBR PLEASE SMC1 <br /> C3�1PlEDICAL WASTe FACSUTY ( FYj <br /> WELL AND SEPTIC P2 RmiT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8_00 Am-5.00rm - EXCLUMNG HOLIDAYS. <br /> 1. 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. fax to(209)464-0138 or mail to the address <br /> indicated above. Address ranges will not be accepted—for additional assistance with file addresses,contact <br /> the EHD.Applications received after 3:04 pm will be processed the next business day. <br /> 2 The EHD will notify the applicant if any 5HD files exist. An appointment for review will be confirmed <br /> approximately ten.(90)days after receipt of.application- The files will be held for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly- <br /> 3- A file that is actively being worked on 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 salve applicant may require'a$93.00 deposit prior to review. <br /> �'4` 1c1r''. <br /> �/3'•ltl L/ <br /> Y• LL <br /> END 46-02-M <br /> V VA6 <br />