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MAY-10-2006 14:31 FROM:CAMPER 80YD 12098238197 T0:4640133 P.1/1 <br /> WWI AW 4000 1.P.Y1 40-101 G7V iRVt'#•Gt7(!4. t rt t Mutt= v1 <br /> AlAtAc KA:1.�C.AYG.f "� ..eIV•YV I.Nt.lwra..� <br /> SAN JOAkQTM COUNTY <br /> ENVIRONMZNTAL HEALTH DEPART'MPIT <br /> hh(� 344 But Weber Avenue,3`4 Floor,Stockton,CA 95202-2708 <br /> 0 V?`-� Telephone;(209)468-3420 F'a=(209)46"139 Web:w ww sjgov cr#ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT' SUSI HEMAOMM <br /> ADOREM b `vs om S' STA <br /> PHOS 11� g@ �. y}'�/ v+ _ PROM^ � FeAy SfM1ilp, : <br /> (Please akw 10 business days from daf of appG=ftn submKid-*Ti m Ontp-mint be eW lMled) <br /> C3 CMCK SOX TO EWE=Ft2QttMT-SS&O Ftp(CASK OR Q=K ONLY)-REQtAEpST AR FM IN 3 89SE40S DAYS <br /> SIGMTURE OF APPLICANT DATE <br /> WMAstion ® Lst a u8P' <br /> PILE ADDRESS EKD USE ONLY <br /> serest At shvd Rain® CR <br /> F.2z. <br /> O unit 1 <br /> ,�'that 2 \\ <br /> 4 <br /> Unft 4 <br /> Q Unit 5 <br /> �. Unit 6 <br /> smcific Date Raftw of Infan=11lon Requested: <br /> UWCiAMM TAKK(M)CLMW SM(LOP) D HOUSSIG AMWXWto INASTd P rt <br /> Q Sits(Nt 4LOP) D FOOD FACUIT 0 r4<m m TAS <br /> TMK(9QWTMW4ftk0VAi) d Doe <br /> KAZARWX WASTE 6 ENk9t MR ®CHMMI RANH ;ZASTOWAIM TMA=Wf PVJ4 <br /> 4 <br /> KM <br /> TIMM P PA E3 NOTEUMUM b PUUMItTMMVyMW TaM'Ts <br /> TATT0Q(0WyP=C1HG ®POOUSPA JKLAwIftEAPPIX&TW51M <br /> KtAeaa UWASTRFACLffY G Onm(PLUM <br /> WEm Amo Sw W P3 r Ram ASE AVASAste FAR -MONDAY-FKMY B:IQ AM4hWH - c lfoaJnnbs. <br /> 'I. List up to tsn adttres,aes in space 00V9. 600a the We(s)of fit"from the list above by checking tate <br /> apprapdate boges). At least one fie type MUST be sol �a�to„(2t�146d-0134 eAr mail the eddreof <br /> d'e taxa o e. Adds range$vAl not be 1110"pted—for additional asst r+cs Stith fain add sA c ct <br /> the EHD_Apptk.Aons necah”atter 3:00 pm will be processed the next businen day. <br /> 2. The EHD will notify the applicant if any EHI3 falai►exI8L An appointment for m_jisw wM be oanfluned <br /> appg ]dmately ten(10)days after swwlpt of appr=tlon. The f Iles+APAH bo 11014 fctr s urea of five businm <br /> days for reuievsr. Appointments should be 10ChOduled a rdingiy. <br /> ew <br /> 3. A file that Is actierely ng Ion by EH® Immediately <br /> not be Imediately av alYable for Tsviear. A n <br /> application may be submitted when the rift IS available, t�FIR3 staff atthe �e of the <br /> d. Any Fane not returned In the same condition as m will be reorganised by <br /> applicant. Futuum file reviews by the same applicant Way Nquire a$53:40 deposit prior to fevlew. <br /> FkV AM <br /> wave" <br />