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u1/21J/2b0b 15:01 9IG-371-1809 <br /> RANEY GEOTECHNICAL PAGELE 01/0 <br /> E C,� . <br /> DATE RECEIVED F;140 LOG NUMBER <br /> SA1Sj0,kQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT IVIgONKST HEAL11 <br /> 304 East Weber Avenue,3d Floor, Stockton,CA 95202-2708 EN MjTfSEVCE8 <br /> -(209)469-3420 Fox, (209)464-0138 Web,www.sjgov.org/chd PER <br /> Telephone. It <br /> PUBLIC RECORDS RELEASE APPLICATION 9 I <br /> APOUCANT- C"r'r e BUSINESSfAGENCY: +-,c C' C"" <br /> ADDRESS, CA"V� <br /> PHONE FACSIMILE: 9/1� -?"-7(— 02 <br /> TENTATIVE*APPOINTMENT DATE,. <br /> TIrm <br /> (Please allow 10 bUaffieSS days ftuM date of applicati-l"Isubmittal-*Tentadvo only-4nunt be confhMed) <br /> CHECK BOX TO EXPEorrE.R7EQU D <br /> _'�?;VA'H.11111 OHECK,0111-y)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> ,3 <br /> SIGNATURE OF APPLICANT _ A DATE <br /> UNtT 171ON 0 unit 1 0 unit nit 3 JLUn 4 ❑ Un 5 0 Unit 6 0 Other <br /> FILE ADDRESS . Aw <br /> rw..tiSE QNLY <br /> Street 9 Street Kluge <br /> U s"T 1i LoI. rA <br /> U,sT Hvi 3. <br /> 7 <br /> Auj5. <br /> tj <br /> CT <br /> 7. <br /> 110. <br /> Specific Date Range of Information Requesttd.From to C;065C&�_ <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> )%5�UNDERr.RQUND TAN {UST)CLEANUrt SITE(LOP) Houstka ABATEMENT 0 SOLID WAsm FACJUTYiVEHICLE <br /> MER CLEANUP SITE <br /> (M <br /> (N <br /> {NON-LOP) <br /> 13 FOOD FACILITY 0 WASTE TRE <br /> XUNt?ERoRouNa TANK(MomrroFuNG1REmaVAQ 0 DOOLKENNEL 1-_3 PAIRY <br /> 3 MAZARMUS WAOM GrIVERATOR 0 CHICKEN PARCH 0 VWAsTEwATrjz TRPAi-Morr PjAmT <br /> &TIP-nPA PERMIT mo FAciuw 0 NOTELMOTM M PUMPER TRUCK/YM0/CHEmTO(LMT9 <br /> 0 TArToof8aoy PIERCING El POQIJSPA 0 LAND USE A"LICATION SITES <br /> M MEDim WASTE FACILrtY 0 OTHER TLEASE SPECIFY) ....... <br /> WUF L AND SiEprnr,PERMIT RmwDs ARE AvA#LAAtr ron REYmEw - MONDAY-FFIrbAY&'QD AM-6:60PM - EEXCLUDIP10 HOLIDAYS. <br /> 4. Litt up to ton addresses in the space above. Select the type(s)of files from the list above by checking the <br /> appropriate box(as). At least one-file type MUST be selected. Fox to 209 -0438 ar . to the add rtss <br /> Inditated.pbove. Addvvss ranges wii!not be accapted—for additional assistance With file addreSses,contact <br /> the EHD.Applications received aftet 3,00 p will be processed the next business day. <br /> . 2. The EHD will notify the applicant If any EHD files exist. An appointment for review will be confirmed <br /> L <br /> T1+...fl!!!-r w';I I f%-hnlod forn,mix!rnum of r1V4!k h!_'_Qlrcs9 <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be inimediately available for review. A new <br /> application may be submitted when the file is available. <br /> .4. Any file not returned in the same r:ontifflon as released will be reorganized by EHD staff at'the expense of the <br /> appliCant. Future file reviewa by the same applicant may require a$93.00 depoelt prior to review. <br /> E140 48-02-006 <br /> 1114M5 <br />