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07/142008 14:35 CLAYT5. "LEASANTON 4 12094640138 F '. -N0.954 0001 <br /> ���I, 64..x.-• �: <br /> 6H0 LOG NUMBER <br /> _ .� SAN JOAQUrN COUNTY <br /> dig ENv7RONMENTAL AEALTu DEPARTMENT <br /> ' f l gSL�LCILB 304 East Weber Avenue,3`1 Floor,Stockton,CA 95202-2708 dT[ <br /> N i I.�Inn I L Telephone!(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/c �.�•`� <br /> L;H <br /> PUBLIC RECORDS RELEASE APPLICATION � <br /> APPUCANT:f 11wir% rtoirtna BU91NEE5S_fAGENCYL tiVC1, IAV r <br /> PHONE42,41^2-41) PHONE(2). r-�-1 irK Z- FACSlWLE:9_0_NZ4^D)ob <br /> TENTATIVE'APPOiNTME'NTnATE. 140v Time: <br /> (Plaasaallowla bURWn daysfrom data Otapplicationsubmittal-`TenfativevWY-mt16t De Confirmed) <br /> CT CHECK BOX TO EXPE101 E REQUEST•Se3.D0 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN a BUSINESS DAYS <br /> SIGNATURE OF APPLICANT 42::L DATE L 6� <br /> UNR DISTRIBUTION Ounit 0Urh2 ❑Unit 3 OUnit 4 OUnit 5 0Unit s O Other(electranldlletgima j '�`E <br /> FILEADDRESS -EHD USE ONLY <br /> Soeet4 Street Name - city " <br /> I 1. da <br /> 2. !qfr I r <br /> 3. rill I I <br /> 5. ler- � <br /> s. I <br /> 7 I <br /> 8. <br /> Specific Date Range of information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNnwenovm TANK(UST)CLfArw SITE(LOP) O Houswa AsaTEneexr SOUDwASTE FAC` �( <br /> THER CLEANUP SnE(N(W-LOPj FIFO FAGDTY WASTE-n to <br /> 777]]HH$$$UNOEAaRDUNOTANK(MDNrmmNGIREMOVAQ UDOG K� a_ DAIRY <br /> �CHAznmlousWASTEGENERAr(IR �CHICKENRANCH i�WAmvhiEnTReAWOne Pum <br /> OT1UdDPERM1TMDFACIUTY i9 Montit-Jam j�PUNPERTRJCrJYAR[1=H1 Th1 . <br /> �f TAT700/60bY PIERCING §1�VOLISPA At"D(in APPLICATMN SMS <br /> fitNCAL WAsrE FACPJTY fj QTHER iPL�As4 SPI�IM) <br /> .WELL AND SEPne PERNR RECORbs AM--AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM,5;00PM - E%CLUDINO HOUDA". <br /> 1. List up to ten addresses in the space above. Select the typo(E)of files from the list above by checking the, <br /> appropriate box(es). At least one file type MUST be selected Fax to(209)464.0158 or mail to the address: <br /> indicated above. Address ranges wig not be accepted—foradditional assistance with file addresses,contact <br /> the EHO.Applications received after 3:00 pan wig 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 /> approximately ten(10)days after receipt of application. The files will be hold for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that is actively being worked an by EHD staff may not be immediately available for review. A new <br /> application may be submitted when the file Is available. j <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expense of the <br /> Applicant. Future file reviews by the same applicant may require a$93.00 deposit prier to review. <br /> ENDUa n <br /> 1NMor <br /> ti <br /> i <br /> 1 t <br />