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ENVIF04WNTAL MALTY" PAU•E 01 <br /> 0310712006 12:45 46401.38 �' Slip Lou Nu>"�H <br /> DATE RECRAD SAN JOA,QUM COUNW •� ' <br /> Ei NVjR0j-; iENTAL HEALTH DEPARTMENT - <br /> ' 304 East Weber Avemvc,3'd Floor,Stockton,CA 95202 2709 <br /> Telephone;(209)468-3420 FS00(249)4644138 Web:www.3j90V-0r8lehdL5 <br /> pUBLIC RECORDS RTLEA.SE APPLICATION . � {l <br /> APPL1CAftT: SUswl!ss/ ENCY: <br /> �C] crrrFAMMILry� raTE <br /> AT3DRESS: lQ(-" <br /> PHONE(10az> /bei "1� � QTY"'.I <br /> TENYATWE"'APPQiNTMeFff VATir:_ <br /> (p(oase allow 10 boeinass dap tMM dace o[a0saaflon ovam Ltal•*7arrtSYh^�only-moat bs�aMt <br /> E3 CHECK BOX TO MXPEDTM?MQUF-ST-(,93.00 PEE(CASH OR QFIIMCK oMy)-REQUEST PRpMSED M a BUSINESS DAYS <br /> SIGNATURE OF APPI-ICANT DATE <br /> flCM <br /> SEM t tit D Nup-Descrf <br /> FILE ADDRESS city <br /> END USE ONLY <br /> t, <br /> sus,s� shame !,)nit 1 <br /> z. unit 2 <br /> � i \ <br /> 4. 3 _ j �' i' ^I rte` Unit.3 <br /> wa. � <br /> s'tUUnit 6 <br /> Specie Date Range of Infomnation Requested:From to <br /> ENVIRONMENTAL.HEALTH DEPARTMENT FILM <br /> ARM ROUNP TANK(UST)WMUP SM(LOP) M Havana AsATIMINT �M WA3TE F,aca.iTrM MICLE <br /> OTHER CLEANUP STYE(Nae-i.OFI i3 FOOD FAMWTr �yAaTE i <br /> Q D0�KyN O CATKY <br /> ROUND TANK(MION1Ta WVu) Ta oHq NRr ►s �WA@TEWAMTJteATWNTftAW <br /> WASTEOMORATOP Q i HIOKli RPM <br /> PLlMFMTWOKMARb IMMALTan,ETS <br /> 'r"ED PIE <br /> FACILM M POOIJSPA 0 LAND USE APM,JMA7kCN SITES <br /> 0 TAlMOMODYPlEROW0 R0-.MR(RI.EA3ESa£C <br /> M01CALWA5MFACLLm <br /> WELT.AND SEPTIC pgn=RECCRM A=AYAILAMIL ROR RMM.MONDAY-PRiDAY S:OO A":ODM - �(CL UDIN6 t iOLroAY3. <br /> 1. Lost up to teal addresses to the space above. Select tTlo type(s)of filge iron!the list above by chMM119 the <br /> appropriate box(es). At lust one 1116 type MUST'be selected. FaY to r90914E4.1a'ISo or mail to the addresscontact <br /> Indi ,rid abgpL. Address Mn9GS will not be aoc.6pted—far additional Agsistarroe with file addMSes, <br /> the EI-10,Appltcatians recelved after 3:00 Pinwill be processed 00 next business day. <br /> Z. The lHp will notify the applicant N any EHD files exist, An appointment for TWA@w will be confirmed <br /> approximately ten(10)days attr receipt of application. The file$will be held for a MgrArnum of five business <br /> dayft far review. Appointments should be scheduled accordingly. <br /> 3. A fll+a that is eoevely being worked ors by E141)staff tray not be)mmediatehf avallabl6 for review. Anew <br /> appijeWton may be submitted when the file is available. r=HD staff at 1MO <br /> 4. Any file not rete read in the__4M9 condition as released will <br /> bemorge a;193�dePo�Ps to revieM►pense of the <br /> appiir.,ant. Futuro file reviews by the same applicant meyrequire <br /> GRO4.09 <br /> 1pJ27l7006 <br />