Laserfiche WebLink
12/03/2004 10: 28 4640138 ENVIRONMENTAL HEALTH PAGE 02 <br /> DATE RE=CEIVED <br /> J SAN JOAQUIN COUNTY EHD LOG NUM$ER <br /> C�� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E Weber Ave 34 Floor Stockton, CA 95205 <br /> (209)468-3 20 Fax: (209) 464-0138 Web:www.co.san;joaquin.cams/ehd <br /> P LIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 'L�"t ( ic.� a BUSINESSIAGENCY:� (�c°�J� �4,L4 <br /> ADDRESS: Ct v c�_. (r1 (/v i ILA C'^�-V 6� <br /> PHONE: Z> Z b'j U U �' X 12 E� FACSIMILE: Z j - Z: -G x !i <br /> TENTATIVE; POiNTMENT DATE- e <br /> (Please allow 10 business days from date of application submittai) <br /> 2 <br /> HECK BOX TO EXPEDITE R QU -$93.00 FEE—REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ✓/ DATE o <br /> rtment Use Only <br /> FiLE ADDRESS UNIT <br /> {!.K <br /> sit '2 L;n c : <br />