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05/27/2005 13:18 949-586-7315 AMES - LUIS PEREZ PAGE 01 <br /> i��ffv <br /> ^�(nnQM.:�(-}� ENVIRIONMEIITAL HEALTH <br /> DAT lJ llE `V' �� !/ `V- D eriu�v,:lw n•.... <br /> SAN JOAQUIN COUNTY <br /> FNVIRONMENTAL HEALTH DEPARTMENT "7 �O Q <br /> `� �� 2 2 2005 "''' Fast l�'eber cnue, 3rd Floor, Stockton, CA 95202-2708 I 1 0 <br /> 1'(lVP'T•.ne• (209) 468-3420 Fast: (209)464-0133 Web! Nv Lv ajgov.orp'elld <br /> ENVIRONMENT HEALTH <br /> PERMITI'SERVICES P('BL IC RECORDS RELEASE APPLICATION <br /> APPLICANT W -- -t � ev$INESS/AGENCY <br /> ADDRESS:.-_ .. 7( �^ �Z <br /> PHONE 411: / [/ J(7 (,7 l. IV <br /> i_!_S{ PH NE(2): rL y .�'D- FACSIMILE; <br /> TENTATIVE"APFC.ImTMENTOAIE: Time. <br /> (PIFAs•aIN w If".rolnsss days from dab of app(leallon submittal-"Tenteebe only-must be confirmed <br /> CHECK BO)'.TC ExTIFO Te?.QUEST-E97. ASH OR - ULIaT PROCESSED IN J BUSINESS OA-- <br /> SIGNATURE OFAPPLICAN' ..r.-_,.. DATE 440 .� <br /> l UNITDISTRIBUTION�•T 77u-d! ❑ Vnit 7 nll4 Q u"a d Unit 4 in Otho(slectronl�/Ilstslmaps) Y <br /> FILE ADDR EHO USE ONLY <br /> —_ — <br /> Streeti 4tEtelName Clq <br /> 6L —4UST <br /> z I , <br /> JV it <br /> 4.3_... <br /> 6. <br /> t . ... _.'. <br /> 9. .- <br /> Specific Date Range of Infemlar fn Requested:From_ to -oQQ-S7 y '/ <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES /��r ��q�+ <br /> / NOER6ROU4O TANK(UST)C_E,•NI�-S'*E(LOPI t7 NOVSM AeATEMENT C)SOLO)WASTE FACILITY FN L iYL. <br /> O�OT/ER CLEANUP SITE(NON-LOP, ❑FOOD FACILITY Q WASIt TAF <br /> tMOEROROVNO TANK(MONITOAINC'v;NOIAL) <br /> ❑DOC KENNEL CJ OAAY <br /> ROWS WASTE GF NEP AlnP Q CHICKEN RANCH O WAeytwATFR TR(ATMFNT PLANT <br /> ❑PooSPA It TRUGUYANDICNEMTOILETS <br /> ❑TRE)PERMITIEDFACILOMOTEtMOTE7PVMRE <br /> 0 TATTOWSOOV PILRCINl USF <br /> 0 LAMP APItICATON SITFS <br /> t7 MEDICAL WASTE FAcnity ❑OTHER(PLEASE SI ECIFY) --.- <br /> W£LL AIIoSEP11C FLY V •1ITCORos ARE AVARAKE FOR REVIEW. MONOAYfAN)AY eT00 AM•e:0oft i%CLUDNIA NOuDAYi. _ <br /> 1. List up to ten addresses In the space above. $elect the type(s)of files from the list above by Checking the <br /> appropriate box(es). At least one file type MUST be selected. Fox 46 178 Or mail to the address <br /> indicated above. Addreus ranges Will not be accepted-for additional assistance with file addresses,contact <br /> the EMD. Applications te.eived after 3:00 pm will be processed the next business day. <br /> 2. The EHO wilt notify the applicant if any EHO files exilst. An appointment for review will be confirmed <br /> approximately ten (10) nays 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 /> S. A file that is actively being worked on by EHO 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 sa released will be reorganized by EHO staff at the expense of the <br /> applicant. Future file nIV Iews by the same applicant may requlre a$97.00 deposit prior to review. - <br />