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03/27/2006 22:59 1209472Tg05 DEUTSCH PAGE 01 <br /> SAN JOAQUIN COUNTY <br /> 20GS APR —5 Vil 10, 03 <br /> T,+,,Ny'YFtQhMFN'TAL 11EALTH nEPARTMENT <br /> -s ;0;,:..; :: : !, s a T'u04 Esst Wcber Avenuc, 3r4 Floor,Stockton, CA 95202.2708 <br /> E Id y'I 0P`i E id T,s ��r,honc: (209)468-3420 Fax. (209)464-0138 Web:www.sjgov,or&hd <br /> HEALTH DEP A-TH-f ii <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> 41 <br /> Bus INESWA43C <br /> ADDRESS: l +���(' &,,jgVek_ cfTY <br /> PHONE(1) 71�_ b7ATE��_ <br /> PHONE(n FACSIFAU.! <br /> ' '��• 'f' <br /> T E NTAT We APrQ0r7WKNT DATE' t im« <br /> (?{awe*now 10 bvskW#d+rs 11,04$44to Or 4pp*Gjtio^wwbaslCW-•TirrtptMe only-hunt W OOCCIM d) <br /> C) CKE=BOX TO LVtVW T-M00 H OR CtIECK ONLY)-REQUEST PKOCEli BD IN a BUSINE S DAYS <br /> SIGNATURE OFAPPLICANT <br /> ti DATE ���—� <br /> a'GftO"i' 0 t-;t C wa-ossori <br /> 4n <br /> Flt-E ADDRESS EHD USE ONLY <br /> trwt V stre.t tuft* <br /> > > [I Uni t 1 <br /> 2. nit t Unit 2 <br /> a. � w1, � w1,- - <br /> 4. gar nit 3 <br /> b' ,eunt4 <br /> s. <br /> 7. y <br /> O U ret 5 <br /> �. 16AA1 A — .. .,� <br /> so. _ 1 O Unit 6 <br /> Specific Date Ranoc of Wo matSan RequAsw:From dS- D to ENVIRONMENTAL HEALTH DEPARTMENT FI! ES <br /> „ rLW,40 t7RouN D TMK(V$T)cLemur errs(LOP) G Hovew;AeA.TOKM ❑SoLm Y(Aatt FA :rflvetucLE <br /> 'F-rQTKM CLGM;JF seri(Kos+-LOP) 0 F000 FActtM O WAM T" <br /> , Npwt0*0 nrz TAM(M�t0K*&1 W0VAL) O C?04 Kriu+� 0 DAARY <br /> —U <br /> .Alltt* RooVSWASTEOtt/1E�a.TVP O RAP" WAt76aAtViTRIIATp TFFAIR <br /> *TORLO PgMgTWV FAc"Ty a M0T'tL A loTdL PL1Sp�Gtl iRu v ruatGAL T 1,I fFs <br /> G TATT0011300Y pLnAceaa Cl PQQV$PA 0 LAMla D UArrucAlIOR StTm <br /> *M10kCAL WAt' FA41UTY 0 QTpL�(%ZASE S?tGfY) -- <br /> Wru.Axo BBPTK FERWT R400WA ARE AVA"LC FOR RF4WW -MON4AY•F"AY 8:00 A^-s:WiR - EXCLu�urO�= <br /> 1„ LW up to ten eddmessos in.the$Pace AbOva. Sele+ot the'"St)of files from the list above by checidng the <br /> appropriate box("). At least ort file type MUST be stleGW. Fane to[20WIMM38 Or Mft tMs <br /> � <br /> JDOJ above- Addroes ring" will not t*accepted-for additional ASrlstan"with file nddressec,conte-': <br /> the EHD.Applications reoolved after 3:00 pm will be procv"ed the next bualnets dry. <br /> 2- The EHD will notify the applicant if any EHD filaa exbat. An appointment fcr review VAU be aanflrmod <br /> approximately ten(10)days after receipt of applioation. The flies wID bo hold for a max mum of five business <br /> days for revicw. Appointments should be scheduled accordingly. <br /> `t. Al file that ids actively being worked on by E-110 Rt%ff may not be fmModlately rvallabla for mviewr. A rew <br /> appll"tion may be submitted when the file is avallabiv. <br /> 4. Elny file not returned in the ammo condition ax released will be reorganized by EHD staff cit lube txpens't Of the <br /> applicant. Future fae reviev a by the some RPOICAnt may require a 03,001 deposit Prior toy reviM <br /> 0 44444E <br /> w3yms <br /> rci "IL",4 Hi-IV3H -Tlit,�OaIN43 SETEb9b DZ:�A SRQziS�/t0 <br />