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Ma r. 16. 2001 2:08PM AT^ GROUP SERVICES INC. No, 0089 P. 1 <br /> EHD LOG NUMBER <br /> SAX JOAQUIN COUNTY <br /> ENV1RON.MFNTtjL HEALT.I3 DEPART-NIF-N ' <br /> 1 6 2007 304]vast Weber Avenue,3'd Floor,Stockton,CA 9; 02-2708 <br /> I'M ?tJl10uirTelephone:(209)468-3420 Fax:(209)464-0138 Web:%vw%v.sjgov.orziebd <br /> :IJI H, ALl:h <br /> PFRi`��'r/SE,RV1CFS PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT::II/6CMwr- M 1164MI /� 9USINESS/AGENCY: /�a Ano ASG S <br /> ADDRESS'�1(I LOWYAW <br /> . Yi O <br /> PHONE(1): ��V"I.IJ I'I L�_ . _.._ PHONE(2): FACSIMILE:tZ005101 -ZZ7-G <br /> TENTATIVE*APPOINTMENT DATE:Much 30 I nol Tlma: 9•o0 <br /> (Please allow 10 business days from date of application submittal-'Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE RE QU -593 0 FEE ASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUS ESS DAYS <br /> SIGNATURE OF APPLICANT DATE V7_2 <br /> UNIT vismouTION Cl Unit 1 n Unit 2 13Unit 3 C)Unit 4 0 Unit 5 O Unit 6 n Other(electronic/lists/maps) <br /> FILE ADDRESS EHD USE NLY <br /> street t# Street Name I City <br /> 1. I 0 i 1 <br /> 2. I 'Z. I 11/1 4 C O h <br /> 3. [?to _ t i v% RJ t i <br /> 4. 0 S. () ( ! i qtn <br /> 5. I D G i pY1 i <br /> S. I 'r <br /> 7 I i <br /> Specific Date Range of Information Requested:From ALL AVA"5LG. to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> l✓UNDERGROUND TANK(UST)CLEANUP SrM(LOP) 0 HOUSING ABATEMENT El sow WASTE FAcn-rrYN cLE <br /> WOniER CLlJWUP$jM(NON-LOP) 11 FOOD FACILITY 13 WASTE TIRE <br /> Gr UNDERGROUND TANK(MONIMRNO/REMOVAL) O DOG KENNEL O DAIRY <br /> M(HAZARDOUS WASTE GENERATOR 13 CmicKE i RANCH O WAMVATER TREATMENT PLANE <br /> dTIatED PERumm FACE= Q MOMMOTEL ❑PUMPER TRUCKIYARD/CHEM TOILETS <br /> 0 TATTOOBODY PIERCING 17 POOLISPA d LAND USe APPLXAnON SIM <br /> MEDICAL WATM FAMM O OTHER(PLEASE SPEcN-Y) <br /> WELL AND SEPTIC PCAWT RECORDS ARE AYALmLE FOR REvIEw- MONDAY-FRIDAY 8:00 AN-6:00PM - EXCLUDING HOLIDAY& <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax to(209)484-0138 or MMI 12 She address <br /> Indlcatgd abQvg. Address ranges will not be accepted--for additional assistance with file addresses,contact <br /> the END.Applications received after 3:00 pm will be processed the next business day. <br /> 2. The END will notify the applicant if any END files exist. An appointment for review will be confinned <br /> approximately ten(10)days after receipt of application. The files will be held for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that is actively being worked on by END staff may not be Immediately available for review. A new <br /> application may be submitted when the file is available. <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 prior to review. <br /> I <br /> I <br /> EHD 4114240 j <br /> �nuos <br /> i <br /> I <br />