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May 12 06 09:16a Bagley Erferprisa (209 •11424 p.1 <br /> DATE REGEtYI=D AN jay w �rq�� TT7�7�q+�� EHQ lflG NUMBER <br /> ^ea�s � 48 V/'�,�RJ Al\ COUNTY i <br /> �J Uri )ENTAL HEALTH DEPARTMENT <br /> \`�• t Weber Avenue. aro Floor,Stockton,CA 95202-2708 <br /> ..,��' ?01 AOT We*-- <br /> 209)468-3420 Fax:(209)464-4138 Web:wwwxjtov.org/ehd <br /> IPIU4W S�la'qwwl <br /> BLIC RECORDS RELEASE APPLICATION <br /> APPL$cANT J � ice_ BUSIXESS/AGENCY:B11gley >aizterprises, Inc. <br /> ADVIRESS:__2170 Maggio Circle, Ste <br /> _4,�Lodx, 95240 <br /> PHONE(1); 367-4800 PHONE(Z:.329-0582 0582 FAc�raaE: 367-5424 <br /> TEti'tAT116tE'APPaiNTNtElvr t)ATE; `S! I2WY 2S 244 Tom: '.' ,. <br /> (PlINkso allow 10 busir da"**m data 4 217$110 46011 strbie KW-Mr&WaVve OnV-nnM be GoMmod) <br /> 13 CitECK sox To Exmon`E R 00 FEE(GAS OR(HECK OKLY)-REQUEST PRiCMEp IN 3 8uSiNESS PAYS <br /> SIGNATURE OF APPUCAIe T 9150tv. DATE 4.r 1Zj2: o <br /> IV it <br /> uN6T taiSTRIBUTIo Q Unit 1 tlsalt 2 C1 unit 3 O unit 4 O U11it S D U111t 5 E3 Qth®r(oWtrankAlztWrmps) <br /> FILE ADDRESS <br /> _..._ . _._.__ END USE ONLY <br /> 5t+wot# 54rest Name 1 <br /> _. <br /> CRY <br /> 9 ✓ fast <br /> a — qura St. <br /> 3. 7(300✓ Mi_charl'GanliS-D CO s) <br /> _4- <br /> 5M,.- W Ho vital Bd. <br /> � /�!��Q7ry�� '(_fDI <br /> _ f_'.i1 .0 <br /> it <br /> French <br /> 8.. 0878 ✓ <br /> _99-N.: Front Vic _-Stockto <br /> Specific Date Range of Infbnm6oa Req :From Jail 12 2003 to 1� 2006 <br /> - - ------- -----EWROPIMEi�'-A-"EA-L-T#-WEPAFffMENT-FILES--- - --- - - ----- - ----- <br /> 0 UmERGROUNO TANK(UST)CLEANUP SITE(LOP) G Hou3;w iiiBATEmEw O SOLID WASTE FACIUTYJV WCLE <br /> R CLEANUP SITE(HON4.0P) O FOOD FACILITY Q WASTE TiRE <br /> Mt RGRgUne�TAW(MO'1i ITORiNVIREMOVAL) a DOO KEmim ®CARY <br /> ®HArARMa WASTE GENERATOR D CHICl%N RANCH C3 WASWWATER TREATMENT PLANT <br /> C]7I6RW PeRNOTTED FASILITY 13 iMoTELmoTEL 0 PUNWER TRUCttl1'AROICHEM TDILETS <br /> ❑TATimeooY PIERcm Q POOLISSpA C3 LAND USE APPLICATION SITES <br /> 0 rAe=ALWASTEFACILITY 13OwER(PLEASE SPEf7FY <br /> WELL AND SEPTIC PERM RECOP=ARR AVAILAOLE FOR REVIEW- i SMDAY-FMAY 8:00 AM$:AQPM - ENCLUOM HOLIDAYS. <br /> 1. List up to ten addresses in the space above. Select the type(s)of tiles from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Pax 121249)4644DI38 or mail W the address <br /> indicated abov®. Address ranges will not be RCG6pted--for additional assistance with filo acldrftsee,contact <br /> the EHE?.Applications received after 3:00 pm will be processed the next business day. <br /> 2. The END will notify the applicant If any EHD filers exist. An appointment for review will be confirmed <br /> appro imatefy tan(10)days after receipt of application. The tiles thrill be held for a maximum of five business <br /> daps for review. Appointments should be scheduled accordingly. <br /> 3. A file that Is actively being worked on by EMO staff 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 ware condition as riftseed will be reorganized by EHO staff at the exper�a of the <br /> applicant. Future file reviews by the same applicant may require a$93.00 dep it prior to review. <br /> EtAD�4o6 ••, ",••• <br /> 9ARlOS <br />