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f <br /> 04/26/2005 21:16 2093698 STEPHEN G.MUIF PAGE 04/04 <br /> DATE KECl=1VE>7. EHb LOG NUMBER <br /> SAN JOAQU�ihi COUNTX • <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, P Coor, Stockton,CA 95242-2708 <br /> Telephone. (209)468-3410 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT` T' �}• M U J aUSINESS/AGENCY: <br /> ADORES$: a ;EOX, i-'F W ab$r2/Ab- C►4- gs—�S g <br /> PHONE(1): ao - X0 -lFye- PHONE(2): zo _(aQ 1 is 6 9 c FACSll4tIl E: <br /> TENTATIVE*APPOINWENT DATE: 0 5- <br /> (Please snow 10 business days tram datin of Application submi"al-'Tenradye only.nnest be confirmed) <br /> 0 CHECK Box To ExpmrTE REQ ST-$93.00 PEE(CASH OR CHECK alvl_Y)-REQUEST PROCESSED IN a susluESS DAYS <br /> SIGNATURE OF APPLICANT 6 . DATE yA-7 dS <br /> UNIT ImsTstiau-ION D Unit 1 0 Unit 2 CI Unit 3 13 Unit 4 D unit 6 D Unit S 0 Other(eiectronkAistshnaps) <br /> FILE ADDRESS EHD USE ONLY <br /> J7. <br /> Street# Street Name City <br /> 5. <br /> U 1C76•/ S a��fobI—;27 <br /> �tl► r M�' - <br /> 5pedf3c ate Range of lnfornm6on Requested:From AS p tiD C U tr 7-ZF <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> it <br /> D UHDEROROUNDTANK(U"CLEANUPSITE(LOP) Cl HOUSmo ABATEMENT D SOLID WASTE FAC?LITYIVaHtuLE <br /> C-*OTHER CLEANUP SITE(NO LOP) ,13 FooD FAeivey ©WASTE TIRE <br /> 0 UNDEROROLMDTANK(M[oNIToRINcMcmoVAL) G Dad KENNEL 0 DAIRY <br /> O HArARDous WASTE GENERATOR G CMCKEN RANCH Q WASTEWATER TREATMM PLANT <br /> Q M RED PERmrTTEO FACILMY t3 N OTELA40 L 13 PUMPER TRUCKIYARDICNEM TOILET$ <br /> D TATTOOIBODY P[McmG Ci PO usm D LANG USE APPLICATION SITES <br /> 17 MEMAL WASTE FACILITY G CTifER(PLt"E Sp=F y <br /> WELL Alva StFRc PERMrr RECORDS ARE AvAILAmm FPR 11 v-N w . MONDAY.FRIDAY 8:D0 AM-6:00wn - ExMUDWO HOLIDAYS. <br /> 4. 1-15t up to ten addresses In the space above. Select the type(S)of files from the list above by checking the <br /> appropriato box(es). At least erre fife type MUST be selected. Fax to 484-0138 or mail to the address <br /> lndlcate above. Address ranges will not be accepted—for additional assistance with file addresses, contact <br /> the EHD.Applications received after 3:00 pm will be processed the next business day. <br /> 2. the EHD Will notify the applicant if any EHD files exist An appointlieent for review will be confirmed <br /> approximately ten(10)days after receipt Of application. The files will be held for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly, <br /> 3. A file that is actiVRly being worked on by EHD istafr may not be immediately available for review. A new <br /> application may be submitted when the file is available. <br /> 4, Any file not returned in the same condition 8s released will be reorganized by EHD staff at the expense of the <br /> applicant Future flle reviews by the same applicant may require a$93.00 deposit prior to review. <br /> }H406 <br />