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06/02/200F 10:31 120994"500 MINIMAX ECR/POS PAGE 02�© ' <br /> 06/02/2066 10:00 4640138 ETNIRON -NTAL. HEALrI 'AGE Eli <br /> OAN OVAAQUIN %.XUNTY <br /> ENVIRONMENTAL HEAL TU MPARTM " <br /> 304 ho Fest Weber-3420Avcnuc�F 3ie Floor,Stockton,CA 95202-2708 Z3cN3 Tdephoat:(209)468-3420 P'az(209)4W-0138 Web:wwwsjgov.gtg/e6d <br /> ]PUR .1C RECORDS ULEASE AI FLICAMN <br /> APPLIC W. C I r< #—f"f LEE <br /> f BU8tN6;NJIAGERCY: ��� _ <br /> ADor�ss: 3 6 9 N• Gam: 5_1t qty S ry u(< N _srAt �G_ 2, <br /> PHOM M.- 'F 6(o- O 3 71 FAcsAl <br /> TEIITATIYEA APPOprrxEKr oATE /S > r (G f k J v n< Maw.. 10 .frt <br /> (rkase rAkw 10 bnslneoa 00"hV M dab of Wks0on WbmMW•`Twb*ve only-malt be confirmed► <br /> C2 CHOCK BOX W 6APPOlTII REQUEST-S99A0 FEE IOA8H OR CWCK ONLY).P OMIT PROCE%.SED IN!BtaWSS DA Ya <br /> SIGNATURE OF APPLICANT. � <br /> ea;Fw c list ti wp-raraoriptieR, �. <br /> rHeeneAtlon <br /> FIDE ADDRESS ERD USE ONLY <br /> aheel re <br /> shadthaw rag <br /> I t. 2-3 r ; M <br /> 9 2 s e �y <br /> a <br /> 6. jeUr►rt S <br /> T.s. Unlit 4 <br /> LEE[ <br /> O MR v <br /> Specific Date flAwJ4 of Ief0 madom Requested:From _ _� O`>` to 6 6 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES . <br /> ,,,R1 tMoEieaxautao'fAAae lUa7/tan N$riE(LOP) o HOUBM AAAMMr O 8mw WAm FAe rTNa w. <br /> )8 On en Ct.eA w arra(Koo-Lop) 0 FOW FAMM M wA9TE TIRE <br /> tMMAe1LMRQTArx(MQwT9 IR :tawAI.) n Dw KEM OL a*my <br /> HArAmws WA=CaEaimvm CCW4=FARM o WASTM&TER TaFOW"FeAAT <br /> O TIM PERAMED PA01iff ❑MoTamo m 0 P/1tWF7t'1RUCNYMa71e.Ht�Mp"JILTOIL6SS <br /> G TATTo0 emy Pimtw- Q P00yaPA 0 LAM Uric Ary mvom Rm <br /> tl MEWCALWAME F1=LrrT ❑OTMR"SASES <br /> YMLAMSM'MPWJWPO;QtPOAMAYALW3MFPORFtNM-MONOAY.FR1QAYa;QQ AAr•9.9" • Eaia�HOLIVAT& <br /> 1. List up to ten addressee in fhe space above. Select the type(%)of files ferns the list above by cheeldall the <br /> apprvprlatn bez(es). AL feast ora file"MUST be selected. Pa cyto n0g)40"12{8 ar mato Te address <br /> indicated above Address ranges vilm not be accepted—for additional assistance Wath file-addressees,contact <br /> the EHD.App Gcatlons reeahrod after 3.00 pm wAll be processed the next business day, <br /> 2. The RHP w111 notify the applicant if any END flies exist An appointment for review will be confined <br /> appraximately ten(10)days after recelpt of application. The files wain be held for a maximum of five busluess <br /> days for mvit-wt. Appointments should be scheduled accordingly. <br /> 3. A file that Is aetivety being w orkad on by EHD staff may not be immedlatey avallable for r„/lecv, Anew <br /> apppcation may be submitted when the fife is avallable, <br /> 4. Any file not retumed In the same oondition as released Will be reorganised by ENO stefff at Lite expewie of iho <br /> applicant. Future file reviem by the same applicant tray require a$93.00 deposit prior to mvfaw. <br /> swam <br /> gwatryw°r <br />