Laserfiche WebLink
05/13/2010 13:12 9254613 BV-BUILDING/SAFY PAGE 01/01 <br /> Y�p O OG LM R <br /> �LD cHT I nn SAN JOAQUIN COUNTY <br /> 1`'7LL,I i�'�^L D ENVIItONM)uNxAI kIEALTHI)EPARTMENT <br /> 304 East Weber Avenue,3d Floor,Stockton,CA 9$202-2708 <br /> MAY �+ i i0 Telephone!(209)468-3420 Fax:(209)464-0138 Web:Wtwt.sjgov.org/ehd <br /> ENVJPI N, DENT HEA Ti I PUBLIC RECORDS RELEASE APPLICATION <br /> PE APPLICANT /� nn /el - BU3INESSIAaENCY: -- <br /> ADDRESS: � 0 `--+�LL'�fN G7 WtdNc GKO C!� —! //J]�� <br /> PHONE(1):02U VU PHONE(2): �� FACSIMILE: '4 a <br /> TENTATIVE'APPOINTMENT DATE: Time; <br /> (Please allow 10 huSlftnS days from date of eppNratlon submittal-"T•enfativc only-must be oonarmed) <br /> E3 CHECK BOX TO rxPEo1TE REQUEST• 95.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN S BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE S�3/lp <br /> UNIT Dl5TR1aUT10N nitl OU 13 Unit 2 0Unita DUnits LT Unite M Other(electmnlGilsWmaps) <br /> FILE ADDRESS EHD USE ONLY <br /> Streal0 5treot Namc city <br /> 3. 1Itr I LIZI <br /> ).A 7, rN ° <br /> s, <br /> 10. <br /> •h.,.t(a� pacific Date Range of Information Requested:From A'46kk to <br /> ! /� �ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> BkT <br /> /1�!NDERGFOUNO TANK(USTI CLEANUP SITE(LOP) n HOU91NGABATEMENT 4r$OLIO W45TG FAaLIWIVENCLE <br /> d HER CLEANUPSITE(NaH-LOPJ CIFOOD FAMLItt wA9Te TlaeOFm ROUNDTANK(MOORIN0IREMOVALia. �DOGKBJN� DAIRYzAnDOUSWASE0FNEtJ CHIOK6N RANCH WASTEWATERTRIATMeNf PLANT //^RE'PERwTTEO FACILITY L 13MOTeuworeL �PUMP@R TRUCWYAROICHCM TOILers 5 'v <br /> TAM01130DY PIERCING 0POGUSPA LT LAND Usa APPLICATION SITES <br /> O MeolOAL wASTr rA01LITY 13 OTHM(PLSA90 SPECIFY) <br /> WELL ANDSEPnc PERMIT RECORDS ARS AVAILABLE FOR REVIEW- MONDAY-FRIDAY S:Oo AM-8:00PM - EXOLUOING HOLIDAYS. <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(2091454-Q13$or mail to the address <br /> indlcated above. Address ranges will not be accepted-for additional assistance with file addresses,contact <br /> the EHD.Applications received after 3:00 pm will be processed the neat business day. <br /> 2. 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 rile 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 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 � rCtJ-119 75 VI /- <br /> 5- i <br /> 5-Z -t 0 L0 o 007A_ <br /> 9R0 analeee <br /> 4laltl4 <br />