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� <br /> Sent By: 0RGWELL & KA8MAN^ INC. 828 932 1807; Oct-7-is <br /> ot 7s 4:80PM; Page 2/2 <br /> FHoLOO woMoFn <br /> ����0 ������|� ��0����� <br /> RECEnlo � � �ENVIRONMENTAL HEALTH DEPARTMENT <br /> OCT � � Y00q GDOEast N1m|nSt. Stockton, CAB53O2-9U20 0 ��~�� <br /> ~°' " " �"°^ Telephone, (28Q) 4O8'3420Fax. (209)4G4'O138V�eb: www.sjgov.org/e �&���r --� <br /> NT��EATH PUBLIC RECORDS RELEASE APPLICATION < <br /> (Please allow 10 business dayr from date of application submittal-"tentative only-must be confirmed) <br /> � I <br /> � <br /> ICES <br /> APPLICANT: 7_0-A% MT0C_Z_k0VjSk� <br /> TFNTA77-VL"APPOF�TMENT DATE: Time: <br /> �] <br /> /w�nVe/w s o ONLY) n ceTpnnceoaeu <br /> SIGNATURE OF APPLICANT /�&h DATE <br /> Electronic Information: Lj List Lj Map—Description: <br /> FILE ADDRESS EHID USE ONLY <br /> Street Street Name City I <br /> SpeE;ific Date Range 9fintormation Requested: From iLk -cb to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES r i <br /> KOIIILR CLLANUP SITE(NUN-LOP) Foot)FACILITY WASTE TIRE <br /> -1 CHICKEN RANCH WASTEWATER TRLA I MLN I PI,ANT <br /> KHA7A[?I)OLJS WASTE.GF NrRATOR'V'— <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR RF=view: IVIONDAY-FRIDAY 8:00 AM-5,00pm(EXCLUDING HOLIDAYS) <br /> 1. List up to ten agdresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> tmx(es). At least one file typo MUST be selected. Fax to(209)464-0138 or mail to the addrG s indicated above. Address <br /> ranges will not be accepted.for additlonal assistance with file addresses,contact the EHD. Applications received after <br /> 3.00 pm will be processed the next business day, <br /> 2, The e*owill noti,ythe applicant|fmnyenDnmovxmt. Aoappointment for review will*oconfirmed approximately ten(10) <br /> uuvnp**,moo/ptvfapplication. The files will heheld for amaximum offive business days for review. Appointments <br /> should oescheduled accordingly. <br /> 3. Afile that is actively being worked on by EHD staff may not be immediately available for review. Anow application may me <br /> submitted when the file inavailable. <br /> « Any file not returned in the same condition as released will bo reorganized by EHD staff at the expanse ovthe applicant. <br /> Future file revIews by the same applicant may require a$115 deposit prior to revlow. <br /> s |fyou need further assistance,please contact Diane Martinez,mt(aow)*88-34o5. <br /> DID USE~ONLY <br /> ! ' ------- ' ------ ---------' ' -------'- ' - -- � <br /> �---- ' — '------------ '— — ---- $127109 � <br />