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Aug 25 05 04:500 Nissa Mad - -n').5-484-1942 p.1 <br /> CA���I I DH>� NUta16E? <br /> SAN JoAQuIv COUNTY <br /> FIN171ROMMNTAL HEALTH DEPART mFN'r <br /> ?04;Beast Weber Avenue,3"d Flom,Stoc:"on,CA 95202-2708 <br /> Pelepborwsa (249)46.3-3420 Fax:(209)464-0138 Web Wv,'w.S;;9,:)v-0z&hd <br /> ENVIRONMENT HEALTH <br /> 2o <br /> PERM/T/SEFiVI PU-BLYC RECORDS RELEASE "PLICA`FIO <br /> AW-MAHT:_19�:f�� _ �`r Wit-' �tfSfttiIESSIAGEPtC'Y. 1 � �1�✓ ___ <br /> Plil)tJ1 11j PHONE(2�: �FAC:SIRIILE <br /> l <br /> T041r'ATIVE' APPOHNITan!NTIDATE. n : <br /> (Please allow 10 business days fzoeo dafr of mWil kation submInal-*Tentative)Only-must l7e comirreed� <br /> C7 cH ECM sox-ro E GIEDiTr <br /> u�U3NsKrT...Ct.ifS"u1RT3U"r�lfl7..il n RaEtQ..L.r..ti:ST- (GASH 0 ECK ONVf) GPROCESSED <br /> __114�3 BUSITNSE~SS DA <br /> YS <br /> SIGNiTU:EOFAPP'IMNT OATIw 04E / 7-- <br /> 1-3 �. <br /> ..-nm <br /> Uri't t QI Unit 2 C3 Unit 3 O Uatt 4 Cl Unit 5 Cl Usnit 6 0 frEfiter .3rrtrnnicllists�Frtsapxsi <br /> - <br /> _ FILE Al{DRESS EHD USE ONLY <br /> Street zt 'Street Name City <br /> r-- <br /> j-. 615 - --- - <br /> RM <br /> A. <br /> '7._ 2 ��_ ��_ii -��� ✓tic f .�.> � ��� <br /> FIT <br /> pcvi#'ia Bate 3R.arTgre cf ltlfitrrll MDn Fb%1 tested:Erorrt <br /> . - - EWRONMENTAL HEALTH DEPARTMENT FILErS <br /> fu->P) �$Gia[I lYhS-�FAAILSTYfEwICLC�JJ.PDERGUIW5A (UST)wLrAmPsmIS - - <br /> )WMER C:♦.i~Rfiv r,]-,E{WM4.0Fj G FOOD FACtM 1.1 Wfu'PE TIRE <br /> Otfrwe4tCi{C'"Jumo7Atte{ D DOC KE MEI. 0 Ewpar - <br /> -f EN= .Umous Wriw.TE rauN tATDR. Ca CHICKEN RAHaH 0 Wrd,rEftf"TF:EATWENT PLANT <br /> ;E%T%jRED PErwn--m. FhrcrrY C3 NWrEldF14 EL []Pud1F£RTFtvaYI`fmWCH vA ToLm <br /> 0'1/%r.VVAl40Y PIFMCMG- 0,POOL/$PA r}LAN USE APPLF PMOH 517M <br /> 0 MevtcALMIAsm F ACILM 0 OTHM(PLEASE SPECIFY)_ <br /> ___1VELLAND SEFMC,PE1RMY-C FT[:•CDF;D3 ARE AVAH.AU a FOR RMEW- IIROMAY^FRIDAY 8:0()Am-5-(Wm - Excuittim WxtorkYs. r . <br /> 1. t_ist up to trate addrer„es ini the space above. Select the type(s)of files from the list L�bova by checking ttte <br /> appropfiate box(es). -At least kart,file type 04UST be selected- Faxtom) -0138 or mail to the addm---,s <br /> indtcalttr d abave- Address rang*z will not be accepted -for additional assistarice with dile addresses,conb-, t <br /> the,EHII. pplicatioris cecelved after 3:00 plra will be processed the next business dvay. <br /> The EKD,wail notIfy the WIaF,carit if aryr EHD files eadst. An appointmant for ri"iew virill ixa confirmed <br /> ap proximat!sly ten(0)da.r s aftai receipt of application. The flies will be held for a rnwdirn.unry of five businkgis <br /> days for review. aAppioint ne.n'LS cbouEd be sche&ded accordingly_ <br /> 3. A file that la actNely being worized on by EHD staff may not be immetliaW ly avallable for re'Oeve. A nor <br /> app;icatiou ma'jr he zuNri tde:d mrtmn the file is available. <br /> eL Allw file nor;returned in the to rrre,condition as released vvl"ll be reorganized by Elim trtar at the experise of the <br /> applicant. future tire!reviews by the carne applicant may require a:$95.00 depu:elt prior to my-weir. <br /> rrnnn <br />