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r <br /> c4av u EHA LOQ NUMBER <br /> SAN JOAQUIN COUNTY <br /> EN 0`0 ON t� Ma n$1L M�Aon, CTH DNT <br /> 9 202-3o2g <br /> Et�At<GE hone: (209)468-3420 Fax: (209)404-0138 Web: www.sjgov.org/ d <br /> irNV1R�Mi ,EMA PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: r-" -- .....__._..-_..._.. ._._..._....,_- BUSINESSIAGENCY;T l-Fi,k. -- <br /> ADDRESS: 3017 Kit mpc gd, Jf tc Im CITYISTATEOP: CA 9100 <br /> PHONE(h): 4116-38V.Dyd`I PHONE(2): ')If- AU-2054' FACSIMILE: 4!4'-r6l-6+110 <br /> T NTATIVES APPOINTMENT DATE. 1cliblo a f;d.-„tcd 4o .�. r.jTime: _ <br /> (Planso afiow 10 business days from date of application submfttal-*Tentative o ly-must be confirmed) <br /> ❑CHI=CK aox 70 CXFI=prrE RmuraS7-$122 KEE(GASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE )2/132/10 <br /> E~let:tronic inform Lis ap Description: til! ocv...a.1 re[.ss 41 4L 2 l ala <br /> FILL~ADDRESS EMD USE ONLY <br /> street# Street Name City Unit 1 <br /> 1• l til6r lingo! S ock!on <br /> 2. aunts f�r� <br /> 4. n3 <br /> AM <br /> $. imp <br /> Imes <br /> t 4' <br /> 7 <br /> 8. p Unit S <br /> S. <br /> 10.� D Unit B <br /> Specific Date Range of Inforrutlon Requested: From 1/1416 --____.-- to 1212003 <br />} ENVIRONMENTAL HEALTH DEPARTMENT FILES - - --- <br /> E NDERGROUNO TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITYIVEHICLE <br /> 1 [ OTHER CLEANUP SITE(NON-LOP) ❑F000 FAciu Y CI WASTE TIRE <br /> [Z)ADEROROUNR TANk(MON)TOPiNGIRIWOVAL) ❑DOG KENNEL ❑DAIRY <br /> I Q HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WaS1-1;WA-Wt TRFATMENT PLANT <br /> i ❑TIERED PERMITTED FACILITY ❑MOTEljHpTFL ❑PUMPER TRvcKIYARDIGMEid1CAL TOILETS <br /> ❑TATTODIBDDY PlOiCING ❑POOLMPA ©LAND USE AOL(CATION SITES <br /> I ❑ MEDICAL WASTE FACILITY ❑OTIIVR(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEWMONDAY-FRIDAY 5:00 AM-S:l)DPt�( XCLUpINC MoL(DAYS) <br />+ 1. List a to ten addre In the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At(east one file type MUST be selected. Fax to A§1-01§§0r mail to the address Indicated above. Address <br /> ranges will not be accepted-for additional assistance with file,addresses,contact the EMD. Applications received after <br /> 3;00 pm will be processed the next business day. <br /> 2. The EHA will notify the applicant if any EHD filer,exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The files will be held for a maximum of five business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that Is actively being worked on by EHp staff may not bo immediately available for review..A new application may be <br /> submitted when the file is available. <br /> 4. Any file not returned In the some condition as released will be reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$122 deposit prior to review. <br /> 014b Usk ONLY <br /> EHO 46-06 o7r2wio <br /> i <br /> TO/TO 39VJ 031Nd1S OEVOT98916 ZT :9T OTOZ/ZO/ZT <br />