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1 <br /> DATE RECEIVED� SAN�„�C�ACZi EJIN COUNTY <br /> �Ht7(.t)(3 NUMBER <br /> f �D <br /> � ENVIi�ON1UlEM1TAt WEALTH OrzPAftTMENT <br /> 600 East Mein Street, Stockton, CA 95202-3029 <br /> APR - 9 2008 Telephone: (209)4683420 Fax, (209)464.0138 Web.www.sjgov, d <br /> .357 <br /> EN`+/!ROW.,U_ ... PUBLIC RECORDS RELEASE APPLICATION <br /> PII�Ri!1iT/ BUSINI=SSIAGENCY: <br /> ADDRESS- 'j,���'j t t� cl— � T_yi1__ r <br /> PHONE(1):2t7 C���-`�—' iLL 5 �PHONE(2) <br /> TENTATNE*APPOINTMENT DATE: Time: <br /> (please allow ten iD"lrm"days from d+rte of apPlicatlon aubmlttal-"Tentative onfy�must bis confirmed) <br /> y .FHECK BOX TO EXPEDITE REQUEST-$9B.0e FEE(CASH OR CHE 3<ONLY)-REQUEST PROCESSED IN THaEE OUSINESS DAYS <br /> SIGNATURE OF APPLICANT _-- fes. - _ � DATE <br /> Electronlc Information; ❑Luta El Map-Description: <br /> FILE ADDRESS EHD NLY <br /> Street 9 Sheat Name y CNy Unit 1 <br /> O r GLfi) Q l S N <br /> g Titbunit 2 <br /> 4, <br /> nit a <br /> 7. 0 Apm UnN 4 <br /> Unit 5 <br /> 9. <br /> �Q O unit <br /> Specific Date Range of Information RogUested: From � to „_,_--- <br /> ENVIRONME'NTAL.HEALTH DEPARTMENT FILES �- <br /> 4HAzAFtDoU13 <br /> �Z17NDERGROUND TANK(UST)CLEANUP SITE(LOP) ©HOUSING ABAYEMENT b SOLID WASTE FACILITYIVEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) 13 FOOD FACILITY Cl WASTE TIar? <br /> UNDEROROUND TANK(MONITORINOIREWOVAL) t3 DOD KI•NNEL []DAIRY <br /> WASre GIENERAMR A CHICKEN NANCk C1 VYAatEWATEk TItEATMEN7 PLAIT <br /> t)TiSRED PERMITTED FACILITY O MaTELIHOTEL PUMPER ATSFATRUCi A TmEN EM TDIT <br /> 0 TATTOOIBODY PIERCING E)POOUSPA C3 LANDER APPLICATION BRCS <br /> Q IIJIFMCAL WASTE FAGLITY 0 OTHER(PLEAaE SPECIFY <br /> l.WELL AND SEPTIC PI_RMIT RECORDS ARE AVAILA94P FOR REWtEw- MONDAY+FRIDAY 0:00 AM-S;aopM - E(CLUQINO HOLIDAY& <br /> 1. List up to ten addresses In the apace above. Select the type(s)of flies from the list above by checking the appropriate <br /> not e a At least one file hype MUST ba selected. �y 4G4.01J8 or rrlall t0 the above addr�- Addross ranges will <br /> not be accepted-for additional asslstaflce with Rio anoressea,contact the EHD. Applications received after 3.00 pm will <br /> he processed the next busineasa day. <br /> 2, 'the EHD will notify the appliCalnt if any EHII file%exist ,qn appointmegt for review will be confirmed approximately ten <br /> Acc <br /> Should be scheduled accordinglingl <br /> days after receipt of ra The thea Will be held for a maximum offlve business days for review, Appointrhents <br /> y, <br /> 3- A flee that is actively befng wo ftel on by the EHD!Staff may not be immediately Avaltable for review, A now application <br /> may be submitted when the file is available. <br /> 4. Any file not rQtumed in the same condition as released will be reorganized by EHD staff at the expense of the C L <br /> Future file reviews by the same applicant may require a 7)9$.00 deposit prior to review. dPPI <br /> END USE ONt,Y <br /> 6 B 10129Im <br /> uaI,IC RECO Rr1'1&1 .A FORM <br />