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rm ). aut (sem: i irm ItKKAbtAK6H 1K N0. 8578 P. 1/2 <br /> WELR IT <br /> D " SAN JOAQUJNCOUNTY C <br /> ENVIRONMENTAL HEALTH DEPARTMENTC Ll <br /> FEB 13 2007 304 East Weber Avenue,3"Floor,Stockton,CA 95202,2708 <br /> ENVIRONMENT HEALTH Telephone;(209)468-3420Fax:(209)46A-0138 Web:www.sjgov.org/ehd <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION y- <br /> / 7513 <br /> APPLICANT: /� <br /> o-(N / r 16USINES,^arAGENCY:_ <br /> ADDRESS: J) (AJ f-` <br /> PHONE{1):,g'1,S ��J'� (D"�.-PHONE(2): ��� L-F—�l ACSIMtLE: <br /> 1 TENTATIVE'APpommEmT DATE 2 FYI <br /> (Piewo RROW lO business days from dot of apphcetlon submidal-•TeMdoYe only-must he confirmed).._ <br /> " CHECK box TO EXPEDITE RED EST.$93.on FEE sH OR CHECK ONLY)-REQUEST PROCESSED IN S OUStN SS DAYS <br /> SIGNATURE OF APPUCAN DATE <br /> Electronic ktformation: ❑Ust❑Map—Descriptlon: <br /> FILE ADDRESS EHD USE ONLY <br /> Street isocat Name qty <br /> 1. <br /> ❑ unit <br /> rk <br /> 2 Ve <br /> 3. <br /> a, tink s <br /> b. prrryyy-�tttt���� �; <br /> �nk4 <br /> 7. <br /> 8. ❑ units <br /> 9. \L 4 <br /> 10. �11nk e <br /> Specific Date Range of lnfomt on R uested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILE$ <br /> VNOEEf RMUND TANK(UM CLEULPSim(LOP) tl HOUsmta A9ATwEHT t7^$r WAsre FAcltlrYrVEwoLE <br /> �h@R CLEArIUP SrIE(NON{.OP) Foao FAaurr ffVV8M TIRE <br /> ,014 WAGUND TANK(MONINRDIOIREmgvAL) LI DOa KeajEL A'D`aRY <br /> S KAmnous WASTE GENmA70R tlCwcKEN RANCH 13 WAsniVATERTREATMENT PLANT <br /> L TISRED PERMnTW CIN0� 13 MoTuftTEL d PUMPEX TRUCWYAR&CHEM TOQEi9 <br /> IN MEDICAL WASTE FACUTY O POOLE EJl.LAWUSE AvPLDAnoN Sim(P(PLSassSP¢alrY <br /> WELL ANPSEPne PERMR RewRos ARE AVNLMLEFVa REVIEW- MONOAY'PAMAY6:00 ANS:00141 - EXgmoM HOLIDAYS. <br /> 1. List up to tan addresses In the space above. Select the types)of files from the list above by chocking the appropriate <br /> box(es). At least one file type MUST be selectod. Fax to(209)Art4-0138 or mail to the address indicated abode. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD.Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2- The EHD will notify the applicant if any EHD foes exist-An appointment for review Will be confirmed approximately ten(i a) <br /> days after receipt of application. The files will be held fora maximum of five business days for review. Appointments <br /> 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 application may be <br /> 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 applicant <br /> Ftdure file reviews by the same applicant may require a$95.00 deposit prior to review. <br /> EHD USE ONLY <br />