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s <br /> 4/18/2005 10:15 FAX 209 94$DI� IM002/002 <br />�- GrA•Lv,a I,V 01V�1, <br /> "Wni 'M� DD JOA.QUIN COUNTY <br /> f ENmon, ENTAL EEALTEI DEPARTMENT <br /> tn , ?�0� 304 E Weber Ave 3`4 Floor Stockton, CA 95205 <br /> 249)4b8-3420 Fax: (209)464-013$Web:www.co.san-joaquin.ca_uslehd <br /> EP VIRDWENT N AETH <br /> pE#tAIT/SE`;VICES PUBLIC RECORDS RELEASE APPLICATION <br /> Ryc� '�3+�st+h BuslN�asrAcNCY: 1✓ ` <br /> APFLMANT, <br /> ADDRESS: <br /> Pl•IONt;: <br /> frS q rL FACSIMILE <br /> TENTATIVE'APPOINTMENT DATE: Y�a45 Tune: /ata <br /> (please allow 10 business days 6-om date of application subatittal) . <br /> 4. <br /> CHECK BOX TO EXPEDITE REQUEST-;93.00 FEE—REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATUR>r F APP["CANT DATE <br /> �j DepadmentlJse Only <br /> L FILE AE)ORESS UNIT <br /> surd `i Oar W. Ga'i`A MO AID Oty Dov i e A ❑ unit 1 5 <br /> 2. VJ. n A MA mad r •�f\\ <br /> a, s �b04 1..1, CA-ITA 'Ra ab 61 Arjoy ZzQaQaU4Unit �J <br /> sued <br /> 41149 d a � ilnit 3 <br /> T. r s -q Unlit 4 <br /> � s� �•❑ Unit 5 <br /> ftext <br /> 2, skex <br /> 90 <br /> •ICNYIRONMENTAL l EA1MTH DEPARTMENT FILES <br /> UNaERR,RouND TAiIK(UST)CLEANUP SITE R•OP) Q HOUSING ASATEh aNT vL SoLm WASTE FAM-W <br /> OTHER'CLEANUP-ITE(HONAMP) ❑ FOQCJ FACILITY 0 SOLIO wAsTE vEHICLE <br /> a uNOERGRoUND TANK(MON(TORINOMMOVAL) Q DOG KENNEL EL DAIRY <br /> k As1npRDpUS WASTEGEHI=BATOR g CHICKEN RANCH �PKG TREAlT�IENT PLANT <br /> © MOTELMOTEL Ea PUMPI:RTRUCKNARD1CHEM TOILET5 <br /> 13 TIERED PERMlIn'51)FACILTTY <br /> TATTOUBODY PIERCING E3 POOLISPA l/WO USE APPL1CA7ldN SITES <br /> O MEDICAL WASTE FACILJTY M OTHER(PLEASE SPE=C! <br /> 1. List up to ten addresses in the space above. Select the type(S) of files from the list above�y checking <br /> the appropriate box(es). At least one file type MUST be selected. l=ax to 209146.4.0a or mail to the <br /> address Indicated above. <br /> 2. EHQ will notify the applicant if any EHO files exist. An appointment for review will be confirmed . <br /> approximately five business days but no later than ten (10)days after receipt Of application. The files <br /> • will be held for a maxllnunl of five business days for review. Appointments should be schedu.led <br /> accordingly. <br /> 3. A file that is actively being worked on by END staff may not be irltmediately available far review. A hey <br /> application may be submitted when the file is available, <br /> 4. Any file not returned in the some condition as released will be reorganized by EHD staff at the o r e <br /> of the applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to evie� <br /> S. rfI=AITATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> :CONFARME[]' i oiN i : : � � �:_ ,TIM>r :�,. , <br /> ENI`dAT e <br /> r; . ., .. •�: .. FAX <br /> ' •� s1N1T.lAL5 �-• � <br /> DAT�C0NPIRMi o 'PHONE : r <br /> REVIEWED .- YES N4 REVIEW DATE. : <br />