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Aug 25 06 04:50p Nissa Mack ""5�i$4 19421 <br /> P• <br /> T^�to LUG NUMBERap �� E:V SAN JOAQUIN COUNTY <br /> E VIRONMENTAL HFALTH AFPA.R'1<mE.Ii T aww_9 <br /> .5 2006 344:East NVebec Avenue,3'd Floor, Stockton,CA 95202-2708 <br /> *3S <br /> Telephown(209)468-3420 Fax:(209)464-0138 Web:v�ry .*`gov.nig/e1.d <br /> ENVIRONMENT HEALTH <br /> PER"✓MSERVIIPUBLTIC RECORDS RELEASE APPLICATION <br /> APNUC:.WT: ALS �� EUSIMESSIAGENC'Y: (�(/l /� "�YI✓ <br /> ADDRESS <br /> PIiANE (1)- �. , � ",+�L t���—PFIDNE(2i _F,AC:SIIhtILE <br /> TENTATIVE'.AfnPOAHTME m'HATE: <br /> (Please allow 10 business daysfrom daft•of aprication sWxnitU1-*'rentativr)only-must lie comirmed) <br /> CM CIJECK.?;0X TO EXPEDITE-REfaliF ST-$ (CASH QP C ECN.CNt.'/)-RECAJFST PFZQGES:aED 1!J 3 I?.U5(NESS DAYS <br /> SIGNATURE OF APPLWAINT _4 � _ __DATE (� a?r�i��_ <br /> VNrf DIsTRn-.U'J1nD8 w 1:3 Linn i a"Unit 2 C7 Unit S 0 Unit 4 C7 Unit 5 13 Unit 6 13 Other(�:irv�mnialisb>lmarrs)�a�� <br /> FILE AO DRESS END USE <br /> _ Street;y _ street f�fame City — <br /> / i. acs.r.r <br /> _1235.3'3. Yslk <br /> �. C. <br /> pccAf ic:(tate t2;�nge of lal'armstion Re cpjested:From, _ toEWIRRDNtM1ENTAL HEALTH DEPARTMENT F'ILE55; <br /> )3 L`NDE•RGR,ZUNU ti ANK(UST)'LFAMlP SrrE JU'>P) C:l DOUSING ABATEMENT 0 aJ'1.JO WASTE FA0IL9TY(wE6 rCLE <br /> 5!rC+TMER GLEAN j 31.E(No"4.0P) f FOOD FAcCu" U Wt ETE MRS <br /> Q DOG KENNEL 1.1 DAIRIT <br /> �O.yFA2-C9Q0US Vh ANK(tflQt ATORVG+r<EYiD't AL) 0 Wpm FEwAlER TF.'EATM:fT PLANT <br /> RTL l'�./1Z.�ARVOus tnrflyTE GlatC•RPTDf;�� �CHICKFTt RANCH <br /> 27-TIFx>=D PE3W'1 ao FACILITY C.l MorrEUHOTEL 0 pu.mPER TRucxrVA Fo/ M TaILETS <br /> 0 TAT°vomtIOY PIF,FKMG 0,,PootlSPA 0 LAND usElupPu.s%paN 5nms <br /> C1 h1E0iCALAAFA5T1:FA:.ILrTY CI OTHER(PLEASE SPECIFY)_ _---- - - ------- <br /> _WELL AND SOMC-PERNrl-FtECDRDSAtSAVAILABLE FOR REew- MompAY-FRIDAY$:013,41t-61OPM - F-XCUII., --HVLIDAYS. <br /> 11. List up to ten acid res ses in the space above:. Select tine typby checking the <br /> appropriatR boxes), At least one file tYPe 14UST be selected. Fax to(209)464:9138 or mail to the address <br /> indie.altnd gbove. Address rang-es will not be accepted—for additional assistance with file addresses,aorttr f t <br /> the EH!).Applications rime red after 3:00 plm Will be processed ttie next business <br /> ;t. <br /> day. <br /> . Th,e END wtliil notify Che ap pli,carit if any EHD files eladst. An appointment for mwiev'Will Ix--confirmed <br /> ai,pro;cimakelly ten(10)da't s aTtm receipt of application. The files will be held fnr a maxitn um of five businw: s <br /> days for review. Appointments:;houlid be:scheduled accordingly. <br /> :3. Al dile that is activelybeingworked on by EHD staff may not be irnmediaiely available for review. A nr <br /> appl'rcatic it may be:ubmilfe:d mfien the file is available. <br /> 4. Atay file nc?�returned in the game conditionals released will be reorganized by FHD staff 31 thPe expense(Yl fine <br /> applicTrit.. I"fdxire WE!revie,,A?s by the same Applicant may require a$95.04 depasit prior to review. 1 <br /> 13(C t9-nc <br /> WI F(a <br />