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rSl�y2131200f 14 40 4640138 EWIROIVZITAL HEALTH PAGE 01 <br /> 'i <br /> "„ "" SANJOA,QUIN COUNTY <br /> '008 <br /> ENvmoNmFNTAL HEALTH DFS ARTmNT <br /> I n' 304 East Weber Avenue,3rd Floor,Stockton,CA <br /> ` 45202-2%0 <br /> telEPfione: 9 448-3420 Fax:t209 46013$Webt www.sj?ov.org/c <br /> c <br /> 7524? <br /> PUBLIC )RECORDS RELEASE APPLICATION <br /> APPLICANT; I DUSINESS/AOF,NCY:- rl�� <br /> ADORESS: 24 �1. IU t� r <br /> PHONE('q: <br /> TENTATIVE*APPOINTU"TDAM' Ill18 or i00ffTime: � <br /> . (ateasea0ewiopusloosadeysfremdateofapplloa0onsubrntuat-•rcnfaweaNy-mustpae�ttrnwd) <br /> fy CHECK BOXTQ EXPEDITE ft s9: FEE fcAsK on CNF-CK oNLY).RrictwST PROCESSEU,IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT —<" RATE <br /> Electronic lnformaHnn: ©List[]Idap—Description: <br /> FILE ADDRESS Ef D USE ONLY <br /> Strait Stjw flame C' Q Unlit <br /> _h o rc ruc db n r <br /> fV11VZT— <br /> � 2. rc qL { r' effYi. UnI1Z <br /> 3. �Z� t G(t TC ` f'Fci GC �� <br /> 4. kn�3 <br /> 5• Unita <br /> tl. <br /> 7. la Unit 6 <br /> 8. <br /> 9. uent <br /> lie, <br /> $pacific Data Range of Information Requaslad:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNomoRouwTAux(Ifs'l)CLvmp Srm(LOP) E3 HOUSM AEATrtdENT J�LSOLU WASTE FAEIL1TYlVFW4U `^" ••Ci �/ <br /> 01Nrx GLEANl/P SITE(WN-LOP) ❑FOOD FAcLrrY PWAFM TIRE <br /> liNomcmom TANK(M0NnoRW—i?EHWA)0( C3 Dog KENNEL 13 VARY jLZIOd <br /> < HAZWOUdWASTE GENesATgRM MCROO NR"W4 WASTEWATtmTREATIA"r M.W <br /> O motm Peniamwo FA=" 13M4TWHOTEL OPuaPeRTReOWYAfm1CNeM TDLETS <br /> �❑`jrr_A11oe/SooYPieFdNe OPODUSPI ❑LARD U3z APP1.10 KSM <br /> `a•Cb7ED1GAl.WArnR FACa1TYx 0 0rH6A IPLEA7e SPEDIPI() <br /> WM AND SEM POW RWOMS Am AVAILABLE FOR REVIEW- UDNOAT-FKMAY 0:00 AM-5:00PM - FL=0RfsHOWAYt. <br /> i. Ltal up to ten addressos In the space above. Soleet the type(6)of Ryes from the list above bycheakittg the appreprlate <br /> box(us). At least one file typo MUST be soloctad. EaKh�'0A ^9211 to the addroga lotfl9go AtMAddress <br /> ranges will not be accepted—for additional aFaiatance with file oddresses,contact ft END.APPII09UQns Teoelved atter <br /> 3:Oo pm wal be processed the next business day. <br /> 2. The EHD will notifythe applicant If any E14D filar exist. An appointment for review will be confirmed approximately ten(10) <br /> days aftor receipt of application. The files will be held for a 9na%lmam of five bustnoss days for ravlaw. Appointments <br /> should he scheduled accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for revlow. A now application rnuy be <br /> subrnivad when the file Lv available. <br /> 4. Any file not retttmed in the same condition as Toloased will be reorganized by15HO staff at the expanse of the op If <br /> Futurefilo ravlews by the sumo applicant may require Y 595.00 deposit prlerto review.•.- <br /> • EHD USE ONLY <br /> Em -09 aamE <br /> TO/TO 39tid S1Nvi-inSN00 I3il 66099vksLG ££ :tT 800E/67/80 <br />