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SEP-03-2010 03 :26 PM GITTINS. ENV&ENG 949 472 0517 P. 01 <br /> ;t <br /> 4 <br /> f►� ;m,(; EHD LOU NUMBER <br /> SAN JOAQUIN COUNTY <br /> Ury ENVIRONMENT <br /> F' O z0{ 1 AL HEALTH DEPARTMENT <br /> 1300 East MaIn St. Stockton,CA 95202.3029 <br /> Tei Telephone. (209)468-3420 Fax: (209)464-0138 Web:www.sjaov.a <br /> L-1�{`.tfr��.. �:ti•I.i'� t i-It-f:f. t <br /> 12 F <br /> fT' PUBLIC RECORDS RELEASE APPLICATION <br /> APWL)CA'kt: v Q Ik hN G tlt+ I h S f5U81NF9s/AGENCY: Csi'M i hIl E KV- +9n `'hc <br /> ADCII I S: `ZZ3 ' Z CITY/STATE/ZIP: M 1 V$11) V; `n CA q26 71 <br /> PHONE(2), FACSIMILE:MJTAT/V 'APPOINTMENTDATE: 7 <br /> Time: <br /> (Please allow 10 business days irgm date o application submittal•"Ton1stive only-must be conflrmed) <br /> ii ).CHECK BOX TO EXPEDITE REQUEST-S122 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> dh4f'orkr:OF APPLICANT DATE 9 -3 10 <br /> farination: Q List Q Map—Description., <br /> i <br /> FILL:ADDRESS EHD USE ONLY <br /> t)tNtli)t 8 8trept Name <br /> city <br /> .2. L mMI4 Rogct $tuck h <br /> s a Unit 2 <br /> �. ..',; L.Od).; 8 Ro0.e1 Stroc b4iah <br /> :. '.4. : "i i .q lv ool��s Rtaa� <br /> Untt3 <br /> ' ��:: : �`il•' : L o a rl las foo,d S°t-oek.fib h, <br /> 9. _ Unit 5 <br /> Unit e <br /> 0;14fft:D a ikga of Information Requested: From— <br /> to <br /> ENVIRONMENTAL H ALTH 0 PARTMI T FILE$ <br /> UF(()���(GRO,UND TANK(UST)CLEANUP SITE(LOP) HOUSiNo ABATEMENT �SOLID WASTE FACII RYNEHICLE <br /> O t Wi o0i:,�itlaila SITE(NoN•LOP) H F000 FaCILm WASTE TIRE <br /> t1N} <br /> 60116TANK(MONITQRINO/REMOVAL) pori KENNEL []DAIRY <br /> H4 11ItQ41(i ASTE GENERATOR H CHICKEN RANCH Q WASTEWATER TREATMENT PLANT <br /> T1 90 FACILITY ❑MOTELMOTEL ❑PUMPER TRUCKIYARD/CHEMICAL 70iLETB <br /> fAii'60*bi PIERCING (]POOtISPA ❑LAND USE APPLICATION SITES <br /> INeinL lhlkgra FaclLrry Q OTHER(PLEASE SPECIFY) <br /> 8uN ."IC,P11RIMIT RCCORD$ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-6:00PM(EXCLUDING HOLIDAYS <br /> )• g�"'dreseas In the space above. Select the type(a)of flies from the list above by checking the appropriate <br /> bb s); '. least one file type MUST be selected. F 2 I In I a Address <br /> alta{I 0�ifll'tiot be accepted-for additipnat assistance wtth lite addresses,Contact the EHD. Applications received after <br /> 3:09'ptrii vVitf be processed the next business day. <br /> '. T f�! Ci0'Wilt notify the applicant If any END files exist. An appointment for review will be confirmed approximately ten(10) <br /> da*a r i`lot:etpt of application. The flies will be hold for a maximum of five business days for review. Appointments <br /> dh'billd bb'ichaduled accordingly. <br /> y. A 0111b*lt41:11 actively being worked on by END staff may not be Immediately available for review. A new application may be <br /> suhh ittid 1iVhen the file is available. <br /> :4. ALV .!!)IM'Mr�it retuPrtad In the same condition as released wllf be reorganized by EHD staff at the expense of the applicant. <br /> Ftil{ejf(lt$jeviews by the same applicant may require a$122 deposit prior to review. <br /> ad <br />