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03/07/2006 12:45 4640)38 ENVI �dTAL HEALTH PAGE E 1 <br /> EHD Lou NUMStm <br /> DATE REMIVEo SAN JOAQUIN COUNW <br /> ,NVRR4NXENTA LHEALTH DEPARTMENT ��1�•��fl�,, <br /> 304 East Wcbcr Avcmuc,3 Floor, Stockton,CA 9520 708 <br /> Telephone-,(209)468-3420 Fs>�:(209)464-0135 Web:yyWW.3jgov.org1Cbd <br /> 4z?M533 <br /> PUBLIC RECORDS RTLEA.SE APPLICATION � n <br /> APPLICANT: SUSWESWAPENCY.. <br /> ibb <br /> rAtE <br /> ADDRESID: r r'�• <br /> PHONE.(I0�9L�6'7 p"QNE(21 <br /> TENTATIVl;''APPOINTMEi�T DATE:_.-,� XC j-', �Z � TAstic- <br /> (lalaame allow 10 b%miness dam t=daa+of 41*002tlon a n►lktt31"'fff4W0 only-must bs*akflR <br /> GI RHEcK i ox To EXPED rE REQUEST-M,00 R8E(C,43H OR OMCK OMY)-RE4ltJt T PROSSEA iN 3 SUSINM DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> BNatrvnic O U& M iAap-Descripttcn <br /> Intormatian <br /> FILE ADDRESF: cloy i:HG USE ONLY <br /> stmotN stieel Name Unit 1 <br /> 1. <br /> �. lam e Unit 2 <br /> a, 3 s �, ; fl.� Unita \ <br /> 7. 1 >. p Unit 5 <br /> 8. <br /> 9. Unit 6 <br /> t0. <br /> Speaiia[Yate Range of Inf fetation RequesWd.From to <br /> ENVIRONMENTAL.HEALTH DEPARTMENT FILES <br /> *DrHot <br /> T�t+K(uSi1 Ct E�WUP SIR(1,OP) 0 Hovapa AAAW AFAT 00WAST.FA0tL1TYtVEH�R4EANUP$TfE(t laN�.01?) Cl FOOD FA41i,nY ASTE T1R6ROUND TANK(MONITORn+G1'Re"WAL) ❑002 KIINNE:� fl QA STWASTEti4 Al OCnpnENRANOM w AIEitTi[eACIr�CN'fPLAfrT <br /> PERIMMEO FAMITf 0 MOIL 071L O LAND U TnucKMARD N SIT I Tan 6T9 <br /> 0 TATroomom PlEF=0 0 POOLISPA ❑ I1�M�U6E APPI N+ATiaN BREE <br /> 0 MmIcALWASTIEFAaurr ❑O'MP,(PI. MSP6CiFYi <br /> X11 U6L AMQ SEVMrr P6AWT F=QRO1 ARE AYAft Aa1.S P=ReAT4-MONDAY FR0AY 8:00 A":0" DOLUDPi61'OLIDAY3. <br /> 1. Lict up to ten addresses In the space above. Select tb@ We(s)Of flies frorn the Ilst above by checking the <br /> appropriate box(es). At lust one file ML#S'1'be selected. F '"Q <br /> 91 �So or ro�aii to the add <br /> aisove� Address f nges will not be accepted.-for a�dditionai Assistance with file addra Des,contact <br /> the EHO,Applications received after 3:00 pm will be processed the next business day. <br /> 2. The l Hp will notify the applicant if any EHO files eAst, An sppointme►nt for review will be confirmed <br /> approximately ten(10)days alter receipt of eppflcatiOn. The fiW will be held for a m*Iimum of five business <br /> days for review. AppoirKments should be scheduled accordingly. <br /> 3. A Me that is aoCvely being wonted ov by EKD staff may not he immediatelY avallablp f©r review. Anew <br /> application may be submitted when the file is available. <br /> 4. Any file not netumad In the same condition as released will $93-00 <br /> 00 depasl prior to revie►Iw"Pe"se Of m <br /> applicant. Future file reviews by the same applicant may require <br /> 6HD 48� <br /> 1pg4f7006 <br />