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_06/03/2005 10:00 916-3719 RANEY GEOTECHNI(* PAGE 02/0 <br /> G NUMBER <br /> SAN JOA. QUIN COUNTX ' 3 <br /> ENVIRONMENTAL HEALTH.DEPARTMENT <br /> J!,IV 0 3 7005 304 East Weber Avenue,3r1 Floor,Stockton,CA 95202-2708 <br /> Telephone: (209)468-3420 Fax:(209)464-01H Web:www.sjgov-oTg/chd 1 %7f0 EV(P,ONMENT HEALTH <br /> 5 <br /> PERMITISERIXES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 64L, o BUSINE�SSI_A{G.ENCY: 6 <br /> ADDRESS: 4'O LALs w d �" ��'-�- V�Pp 7 <br /> 2. <br /> PHONE(1): 6 3 PHONE(2): FACSIMILE: (q 16 3 ( a <br /> TENTATIVE'APPOINTMENT DATE: L/_'142 'S Time: 0110 0 (} <br /> (Please allow 10 business days from ale f KPACaaon eubmlaal-'Tenwvve only�mustbe cennm+ed) "/1_� <br /> CHECK BOX TO EXPEDITE REQ ST (93.00 FEE ASH OR CHECK ONLY)-REQUEST PROCESSED INS SUS NESS DAYS j-, II n'Q <br /> SIGNATURE OF APPLICANT DATE <br /> UNIT DISTRIBUTION 13 unit 1 D U nit K4 0 UnR S Unit a 0 other(alectronlcAlstslmaps) <br /> IL <br /> FILE ADD _. ., . — END USE ONLY <br /> StroetB Skeet Name City ...____tvl� s���ktTL4. <br /> 5. ..L 6 ,v O. <br /> 7. <br /> 9. ' <br /> 10. <br /> Specific Date Range of Information Requested:From 1�q5 to <br /> - ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> DEROROUND TANK(UST)CLEANUP WE(LOP) ❑HOUSINO ABATEMENT HScup WASTE FACKMIVeRICLE <br /> �ER CLEANUP SnE(NON4.OP) C3 FOOD FAcaJTY WASTE 7mE <br /> ;Ir TANK(MONITORINGJREMOVAL) l7 DOG KENNEL DAIRY <br /> X114'=1 Ftno1E WASTE GENERATOR 13 DNICKENRANCH 13 WASTEWATER TREATMENT POINT <br /> ®-nanen PERMRTen FAG4ny 0 MOTEUHOTEL 0 PUMPER TRUCKNARDICHEM TORETO <br /> O TATTOOMODY PIERCINO 13 POOVSPA O LAND USE APPLICATION SFM <br /> ❑MEwcAL WAarE FAG(ur Y M OrNEK(PLEASE SPECIFI'I - <br /> WELL AND SEPTIC PERMR RECORDS ARE AVAILABLE PW REVIEW- MONDAY.FRMAY 9:00 AMZ:OOPM - EYCLUDINO HOLIDAYa. <br /> 1. List up to ten addresses In the space above. Select the type(s)of files from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax to(2091464-0138 or mail to the address <br /> Indicated above. Address ranges will not be accepted–for additional assistance with file addresses,contact <br /> the END.Applications received after 3:00 pm will be processed the next business day. <br /> 2. The END will notify the applicant It any EHD files exist. An appointment for review will be confirmed <br /> approximately ten(10)days after receipt of application. The files will behold for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that is actively being worked on by END 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 same Condition as released will be reorganized by END staff at the expense of the <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> EII04e-02are <br /> ip4a5 <br />