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DEC, 27. 2006 3:21 PM , .,C R EARTH TECH _ N0, 0666 P,- 2- <br /> SAN JOAQMN COVNrY <br /> RNMoNmxNTAL MA,L=DTsPARnam <br /> 304 Past Weber Avenue,3rd Moor,Stockton,CA 95202-2709 <br /> Telephone:(209)468-3420 F=(209)464-0138 Web:www.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLIGArNT: ,6A lJq tJSIN6SS/A1 , 5 <br /> AbpRESS` R�..l�VVY�t <br /> PHONE(1r 7�r�9 Z� �'E)o�l� PFtoNE(2j: (01-�OD2 19ACGIM1Lr.�2Lxt� <br /> TENTATLYE'APP4lNTMBNT PATE: t1 Tlmo: Z — <br /> (Pleme atlow 10 business days tom date,of I d n sub:xhitWt-'Tentative Qn1y-must be confirmed) <br /> C3 CWGCK SOX TO M(PED RE -Sgs.co re OR t�ONLY)-RF-QUEST PROCE3SER IN 3 UStN $DAYS <br /> SIGNATURE OF APPLIC DATE <br /> Etectronlo information: ❑Llst C1 Map—Descriptio . <br /> FILE ADDRESS EHD USE ONLY <br /> stmt li Street lame cityr 1- 40!5 <br /> ❑ Unit t <br /> 2- ❑,Unit 2 <br /> 3. �vYj w -hNtit 3 <br /> 5. unit 4 <br /> \' l3. 1�15� r�-, �'��-'rte. �v:1 � D • <br /> 7. f�-� 60 nits <br /> wS o. 1'11kk- <br /> , <br /> s. d9`1 .4, v�,e•'+riw ut!?. unit8 <br /> va. Sr iC> <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH I)EPARTIVIPINT FIDS <br /> ' .):JM VASRouND TAw(tiS71 CLEAmp Stye(LAP) 4w=G Aa3A70NNT o WARM F=Xr dVEa=Z <br /> ia1mCLEANOP SftE(N'oN.LOP) 0 FOOD FACKM CI WASTE TM - <br /> NDMMWVrm TANK(MONVIUMOM MOVAL) 0 Doe KENM ®DAIRY <br /> A HAZARMUS WASM GENERATOR 0 Ca(cm PUNCM 13 WASTEWATER TREATMENT PLANT' <br /> 13MEED PEMM PACQ.ITT o MOTIMMOTEL ❑PUWFRTMJCKlYARDjQiEMTOILEIS <br /> C3 TATTWBODv PmRCKIG CI POOUSPA <br /> 113Wd0 U AvPLICAT10N SatES <br /> C3 MEDK:AL WASTE FAcu.nr Q OwmaR On -Ase SPa <br /> WEu.AND SEP=Pww Reams Am AvALABLE FOR REvasvu• MONDAv>+�kIDAY 8:00 Ana-S:ooPA! ExCLUDu�G HauDAv9. <br /> 1. Ust up to ten addresses lin the space above. $elect the types)of tries from the hst above by checking thQ appropriate <br /> box(es). At least one file type MUST be selected. Fax to(2o914fz4-0138 or mail to the ddress lndicatea above. AddressAN <br /> ranges will not be accepted—for additional assistance with file addresses,contact the EHD.Applications received after <br /> 3:00 prn will be processed the next business day. <br /> 2. The EHD will notify the applicant If any EIID Bios eXist. An appointment for review will be confirmed approXImatety ten(10) SIX <br /> days after receipt of application. the files will be held for a maximum of five business days for review. Appointments <br /> Aft <br /> should be scheduled accordingly. <br /> 3. A file that Is actively being worked on by MD staff may not be Immediately available for review, A new application maybe <br /> supmittad when the file is available. <br /> d. Any file riot returned In the saner condition as released will be reorganized by EHD Staff at the expense of the applicant. <br /> Future file reviews bythe sante applicant may require a 595.04 deposit prior to review., . <br /> RHO USE ONLY <br /> EHG4&QG - - <br />