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X2/2005 15:43 2097959553 APERIO INC PAGE 02/0 <br /> un0r 3/22/2v0G8{J5 <br /> 15:38 454 ENVIRONMENTAL et�,LTHY+ u rcPAGE,LtY01 <br /> SAN JOAQICO <br /> ENVIRONMNTAL HEALTH jJ <br /> 304 East Weber Avenue, 3T4 Floor, Stockton,CA 95202-2708 <br /> Teiepboao:(209)469.3420 Fax:(209)464-0138 Web:www.ejgov.org/e22 ptfh <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPi.IGA►rZT: Vol11URiNE85/AGEW-Y: A pgwi T Y <br /> ADOWSS. ,no\d CW_ qrz 2� P A tt hWAs i t <br /> MONEM- ALL:-211'_' PHONE(2): ME �j r= <br /> TENTATIVE*APPOINTMENT DAM_49(11 1,,2,005— <br /> rte: . ID=Oo ci,r,-, <br /> (Plame affaw 10 bunlnse n days from date of applicaton submlltal-*TcntWw only^moat bo onfirmed) <br /> O OHC-CK BOX TO EXPEAITE REQ ST-693.00 FEE(CASH oR CHE x QNVY) REOLIBEST PROCESSED-IN 3 BUSMS DiAVa <br /> o7 <br /> Dos <br /> SIGNATURE OF AP pL1CANT ollDATE .3 T <br /> UNri DI3TRJ8UTl0M ❑UnIt 1 ©U*2 nit 3 4/43 Unit 5 unit 6 0 Oftr(oltlov=Ienizw=F a) <br /> FILE ADDRESS w.--__ WD USE ONLY <br /> street sitreat Name tdq► <br /> ANWYNZ j< o2 Oj 4 <br /> P\.. <br /> 8, <br /> 4. 24 :\ AL <br /> S. <br /> 6. <br /> 7. <br /> 8. <br /> 5. • <br /> 10. . <br /> Specific Daae Range of InfoonAtion Requestad:From to <br /> ENVIRONMENTAL.Hi:ALTH DEPARTMENT MILES <br /> to UM33maROemme TAM(UST)C:LOANUP 1917E(LOP) In Hamm AxAT=NT V COW ilVAITO F/lM-IrY/V4tN LA <br /> Jil OiWR CI.EAIeulP Sm(NON-LOP) 13 FooO FActm 1$WASTE ME <br /> 6LUq=oao=R TANK WwraalraalR AMAL). <br /> G'?HAZARDOu.4 WASTE GENERATOR d CHICKEN PARCH in wAs-wwATER TARATLMNT PLANT <br /> 0 TMB9 iGRl411M FAM1TY 0 M:G7 UMHOM 13 PWAPER TMjCYVYARDfCWM TORZM <br /> 0 TAT7aaMMY P040M 0 PCOU3PA q LAtta USE:A" QATM 8ITE0 <br /> 0 idwcAL WASTE FACMM 0 QTHR(PLEASE SPECIFY) <br /> WA"AMP SAM Pmt RMORM AaR RW <br /> MV Mq RMV- r3OMMY-RUPAY 4,00 A":oal'a+ - EXtx t>=G HoLIaAY& <br /> t. Last up to ten addresses in the space above. Select thq types)of files from tie list above by checking the <br /> aWmpdau be gam), At ls*ct ono file types FAUST Nae seie t+atl. 64.0138 or mail to the address <br /> indicatetabove. Address ranges will not be accepted—for addiltionai assistance wlff+file addresses,contact <br /> Mo 1:HD.Appllewons received Aftr 3%00 pm Will bo processed the next busine w day. <br /> 2. The i HD will nobly the applicant if any EHD flies exist. An appointment for review Will be confirmed <br /> approximately teen(1 D)days after receipt of application. The tilos Ata be hold fat A lnuximum off a buelnelss <br /> days for review. Appointments should be scheduled accordingly. <br /> S. A rile that it actively being worked on by EHD otsff may not bo lrnmedistely Malta <br /> bio Oar rpvleew, A hQ�W <br /> application may be submitted when the file is available. <br /> 4. Any file not returned in tiro came condition as mloac na rwill <br /> be p�98.�anteed npe;�Ilt pEHO�to rm►io�ns®o€the <br /> €lpplicant. Future file reviews by they saline APP11 <br /> y aQ <br /> 7N1MIb4 <br />