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09/29/2006 1.1.:.29 FAX 1./ � 002 <br /> FH �C�-td!'1;0i18R <br /> (� <br /> (r' °_- JAN JOAQUIN COUNTY <br /> Rgug�VFED ENNIMONMENTALHEALTH DEPARTMENT <br /> 304 hast Weber Avenue, 311 Floor,Stockton,CA 165,1202-2708 <br /> 2 g X006 <br /> SEP Telephone; (20w <br /> 9)468-3420 Fax: (209)464-0138 Web: ww.sj9ov-orgleh:l2 ff <br /> ENMRONMENT HEALTH PUBLIC RECORDS RELEASE APPLICA7:ION <br /> BUSINESS/AGENCY: <br /> :4-c <br /> ADDRESS: 3410 PHONE(2):616) �-7156 <br /> 2 Z3U-7e , Ci4 <br /> PHONE <br /> FACSIMILE: ZO L�f- J 72?-_, <br /> TENTATIVE°APPOINTMENT LATE: Time: <br /> ` (Pieass al!uv to business days from date of application submittal-'Tan Wive only-must 1>1 cenfimsed) <br /> r 1,ECH BOX TO EXPECiTE RE I -$93.09 FEE <br /> (C OR ECK ONLY).REQUEST PROCESSED IN 3 BUSiNEas DAY,`.' <br /> 01,E <br /> � � 1` O <br /> SIGNATURE OF APPLICANT x DATF. 9/2-4 <br /> Uidn rNSTRiDUTION O Unit 11 Unit2 O Unit E3 Unit4 13 Units [3 Unit 0 other(e'actronic(iists/rape)) <br /> k <br /> Fi° E ADDRESS <br /> -._ EHD USE ON f <br /> 220�p. �' .etx street Name <br /> A' str1Vceet <br /> 7J401� TLac 1.15'1.._ <br /> � •f <br /> 5 �� C-PANT. _ 5+4 _ TtAay 1h51G�iV eft <br /> AiZTKv4 2-4,01 <br /> a^ a 7< 60N]TttAits..I'fa <br /> 51 ( $a.5 uocP 2a5 ia/ St�a <br /> Z3°fU 6 3ti0S !_ _ Rl!k5MAW Rb.s. 2390f_..... TEwcIL_ uar <br /> LLS <br /> ..... . UST .. . . \� <br /> � � _777 , _ ti ITA s T tri _ <br /> T c Tru <br /> 11`4+ ) 1 FI_Ev )' m 5T b4 <br /> SpeciFc Date Francs'of information Requested:From to -- -- ----- <br /> ENVIRONMENTAL HEALTH DEPARTMENT FIL S <br /> tJ\DEAGRCaI}ND TAIT4(UST)ciEANUF S!'!E(LOP) ❑NOISING ABATEMENT <br /> OTHER CLEANUP SITiE(RON-LOP) CI FOOD FActuTY <br /> UNOERGROUND TANK(MONITORIN31REM04AL) 0DOG KENNEL K ,TREATR9ENT FlAIYT <br /> HAZARDOUS WASTE GENERATOR MCHICKS CH <br /> �iERED PERMnwD FACILITY ❑mowL _ Jr %KNAHD(CHEM TOILFTfi <br /> E3 T.A7TOO15ODYPIERCING ❑PooLfS .T AFPLICATIONSITESUl <br /> C'N!L'DICAL WASTE FACILITY 0OTHER( -SF ):. <br /> 1r1ELL AND SEenC FERMn RECORDS ARE AVAILABLE FOR REVIEW- MO AM^5:00P - F%CL DA40HOLJOAY5. <br /> 1. List up to ten addresses In the space above. Select the a of fit Is f m the It above by checking the <br /> appropriate box(es). At least one file type MUST be select Fax to 0 64-0138 or mail to theaddress <br /> Indicated above. Address ranges will not be accepted-for additiona assistance with ffie addresses,contact <br /> the EHD.Applications received after 3:00 pm will be processed the next business day. <br /> 2, The EHD Will notify the applicant if any EHD files exist. An appointment for review will be confirmed Q <br /> appreslraately ten(101 days after receipt of application. The files will be held for a maximum of five btrshmesL <br /> r r revTw . Pppo4-tmsrats should be scheduled accordingly. <br /> 3. A fit-,that IS;actively being IuOrked on by EHD 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 EHD 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 /> I <br /> -cYG?RYtOM <br />