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DATE RECEIVED END LOG Nl1MSER <br /> SAN ,1UAC2UIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St.-'Stoekton, CA 95202,30,9 <br /> Telephone: (20.9)468-3420 Fax (20.9)4"0138 Wets: wwW-Sjgtyv..org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION. <br /> APPLICANT:-W S(cc P fhc 113-b5 BUSINESS1AGENCY:�A-C' <br /> CITY/STATMP: t i7 (17f�2p�C��QI j� <br /> _ G� <br /> PHONE (9): 510 `i�T - 1 ��rJ PRONE(2) 0 '06Zq I`ACSIMILE (C- � (�-��`� <br /> TENTATIVE'"APPOINTMENT DATE (�l:. 'ZTimers- r n <br /> (Please allow 10 buslrness days from Bete of appllcatlan submittal-"Tentaflve on y•must ba corrt-Tnned) <br /> ❑ CHECK 13OX TO EXPEDITE REQ E: 125 FEE(CASH OR CHECK ONLY)-REQ . ST PROCESSED IN 3 9,11SINESS DAYS <br /> SIGNATURE OF APPLICANT DATE Z"7 12---, <br /> Electronic Information: ❑ List O Map-Description: <br /> FILE ADDRESS <br /> ENDi.iJSE ONLY <br /> Street# Street Name City <br /> act Rv`ro Unit�_ <br /> AZA Pq TRA I �jOC- S� D <br /> rwo 1 tQ- ❑Unit 2. <br /> TR-A C14 <br /> S�N'9 <br /> a. 13""""3 2 <br /> iln(t 3 <br /> 5. <br /> 6. � <br /> L'! ritt/ <br /> -- --------- U4 <br /> T - - <br /> -- ---- ❑unit 5 <br /> 0 Unit e <br /> Spedflc Date Raiige of Iriform6tion R"UsMsd: From to <br /> EIdVIRONl1RENTAL•flEALTH DEPARTMENT FILES <br /> ❑ DERGROUND TANK(UST)CLEANUP SITE(LOP) El ❑Housika ABATEMENT SOLID WASTEur <br /> FACyNEHICLE <br /> [OTHER CLEANUP SITE'(NON�LOP) ❑FOOQ FACILITY ❑WABTETIRE <br /> ❑ ERGROUNO TANK(M(*ITORIW4 REMOVAL) ❑DOG K Mall ❑DAIRY <br /> AWbbUSWASTE%NERATDRQQCH kt ❑ <br /> NRANCH WAMWATER TREATMENT PLANT - I <br /> ElTIE110 PERMITTED.FACILITY ❑MOTE11HOTEL ❑P4MPER7RUCKIYARDXHEYICAL'Tod(ETSI� <br /> ❑TATT.fIf,1IBODY PICRCINO. ❑ 8PA ElLA`w USE APPLICATIONSITES <br /> El mwfIIIASTE FACIuTY COOPi:AINr REdmos. ❑O*ER(PLEAsespm" <br /> WELL AND SEpfld PEOMIT'RitcogO9 ARE AVAILABLE Fdfi F26 itW: M6NDAY.'FRi6AY$'.O0 Am4 00om(t)(6L:IIDING HOLIDAYS) <br /> 1. Ust un to ten addresis In tie space abovo. Select the type(F)of flles from the list;above by thipOdng the.appropriate <br /> box(es).. At least'one file type MUST be selected Fax.to t20it1 +4-013x1 cir'rnw toAhe mss Iridlow6W oboVe Address <br /> ranges Will not be accepted:-for additional assistance with file addresses.contact the'EIiD. Applications.received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will.notify,the appilcant if any EHD A-]as exist-. An appointment for review wl11 be:aonf nmed approximately ten(10) <br /> days after rebelpt"of applicatlon'. The files will be held for a'm4kimurh of five business days for review. Appointments <br /> should be scheduled.accordingly. <br /> 3. A Me that is ectively being worked on by BID staff may riot twimmediately avallable for review. A new application may be <br /> submitted when the 01als available. <br /> d: Any file not returned in the same condition as,released will be reorganized by EHD staff at the expense of the applicant. <br /> Future file roviews by the same appllcant may.requires$125 depostf for to.review: <br /> alp l,ug'w,owv <br /> E o 46-n — <br /> ar n <br />