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0 q <br /> 05/13/2010 13: 12 92546013 <br /> 13 13V-BUILDING/SAW PAGE 61/01 <br /> 013 UN R <br /> I PR <br /> _7 "', "I�_- <br /> II 11 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 Fast Wcber Avenue,3"' Floor,Stockton, CA 95202-2708 <br /> Telephone!(209)468-3420 Fax: (209)464-C 138 Web.www.sjgov.org/ehd <br /> E N V1 <br /> ri <br /> "F _i PUBLIC RECORDS RELEASE APPLICATION <br /> PE <br /> APP ICANT' -Uel 14 RU8INE$SjA(3ENCY:_., <br /> ADDRESS:-a13112 vvte�llt 2121 It? <br /> PHONE{i): PHONE(2). <br /> TENTATIVEk APPOINTMENT DATE: Time; <br /> (Please allow 10 bUtint"days from date of application submittal-*Tendativa only-must be canflrmK <br /> 0 CHECK BOX TO EXPEDITE REQUEST-$93.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 33 <br /> SUSINEn!;DAYS <br /> SIGNATURE OF APPLICANT DATE 5/(,3 <br /> UNIT DI5T1311311fl;; FU',Jt I In ULJ Unit 3 C Unit 4 0 Unit 6 0 Unit 1 0 Other(electronicilirts/mapr) <br /> FILE ADDRESS END USE ONLY <br /> Street Name I city <br /> F. Lpindsck, <br /> E , r n --,A .1 .- . - . <br /> 3, _ <br /> 10. <br /> t <br /> 'i a- Af CV1 I uc� A Y) <br /> -ApLcific Date Range of information Raquimfed:From Oil 45V Vv%/c,N-C to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> NDn7tGROUND TANK;U$11 ct-rANUP srrF(LOP) M HOUSING AMATENS0 W/ <br /> $0LIDWAsTr-FAC11LITYIVENCL <br /> 1 <br /> :�o <br /> ,PIKER C7LV_ANUI-Slt�(NON-LOP) 171 FQQDFAC1Ury ErWASTE V-411 <br /> KrnrRWOUIM TANK(MONIT0R1h01RENOVAI,)V1 0 Doc KPNNEL 12 DAIRY <br /> WAzAnDuLFs WA31E GENERATOR 0�1 0 CH icKC14 RANCH 0 WAuttwATrrzTAZATMFNT PLANT <br /> az�cnco PRnmirmo FACILITY C7\ 0 VICTIELIHOTEL M PUMPER TRUWYARDICHam Tonm <br /> 13 TATToo/Bovy PIERGINO 0 PDOUSP)" 0 LANG Vs�AppucATinm Saps <br /> 0 MeoIcAl-WASTE FACILITY 13 OTHM(PLEASE SPECIFY) <br /> VVELL AND SEFTIc PERMIT RECORDS ARE AVAILABLE FOR PVAEW- MuNPAY-FAMY 8.00 AM-5:0013M - E=LVCING HOLIDAYS. <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the fist above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax jo(20.9).,45A-_QJ3 or mail to the ad,0regs <br /> Ind j,qajgd above. Address ranges will not be accepted—for additional assistance with file addresses,contact <br /> the EHD.Applications received aftAr 3:00 pm will be processed the next business day. <br /> Z The EHD will notify the applicant if any EHD files exist. An appointment for review will he confirmed <br /> approximately ten(10)days after receipt of application. The files will be held 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 EHO staff may not be immediately available for review. A now <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 gxpense of the <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> f <br /> IY�;TiAJ <br /> 5 <br /> o ('0/14 00: -�`7 le—1,J1 L_Z0-I WN <br /> 15 » (Z <br />