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An, 21, 2000 3:05?N Ado ed Geo Environmental � �0 5912 p 1 <br /> DATE RECEIVED EHD wv NUMBER <br /> SAN JOAQM COUNTY' <br /> REC(�OiIj11,�(n, ]ENVIRONMENTAL HEALTH DEPARTMENT 1) <br /> L� V L�U 304 East Weber Avenue, 3`a Floor, Stockton,CA 95202-2708If <br /> AUG 1 2006 Telephone: (209)468-3420 Fax:(209)464-0138 Web:www,sjgoy.org/ehd i <br /> A <br /> ENVIR PUBLIC RECORDS RELEASE APPLICATION �/�t �A <br /> 1 TI I <br /> �lCN7;R e� BUSINESSIAGENCIAV(�F1(Q. <br /> ADDRESS: 'j�a c11 �D A S`� D C!L h 0 t>J A <br /> /ZI/o& PHONE (1):�.Q� 11?L7 �PHONE(2):p�Q4 ^/1�? - �a~LV—FACSIMLE:. 7 [ <br /> ((teal q//a 4. d 1ENTATIVE"APPoINTMFN•r DATE: T1m®:__ <br /> t hL,-((cvrow (Pieaso allax 10 business days from date of OPPllcatlon submittal-*TonWve only-must be confllmed) <br /> n a 95,P CHECK a.Ox TO EXPEDITE RE £7. 45 <br /> RtE(C S OR C CK ONLY)-REQUEST PROCESSED IN d BJSINESS DAYS <br /> SEG 1URE OF APPLICANT DATE aC Wr <br /> t <br /> UNITDISTRISUTIUN L7 Unit1 Unit nit nits ❑ Units ❑ LinRB ❑ Other olectennlcll /ma s` <br /> --_ _ ( P <br /> FILE ADDRESS <br /> Street! Street Name city EHO USE ONLY <br /> f. q O 0 <br /> 9. -J-Liz-�--k113�'C�_Is� ;1►_QE I FF _ w <br /> 4. ------ — �_ <br /> — QI7-2 <br /> Specific Date Range of Information Roqussted:From - to - 7ftda <br /> ����JJJJENVPRONMENTAL HEALTH DEPARTMENT FILE;; "e , '0THUNMW RFANDTAIII((UST)CI.FANUPSITE(LOP) ❑ HOUSING A@ATEMENT ❑SV-"P WASTE FAMITYNEHICLE ��� N <br /> INE.OTNER'DLEANUP SIrt(NON-LOP) ❑FOOD FACILITY ❑WOGTE TIRE <br /> UA2ARGROUNo TANK SNSpA0NINGIREINCVAl) ❑ Doe KENNEL ❑DAIRY <br /> ,HARARDOUSWASTEOEILBRATLNt ' ❑CHICKEN RANCH ❑WAS-, TREATMENT PLANT <br /> 4 TIERED PERpIITrED FACILITY IJ❑ MoTELSPATEL �❑PUMPER TmuciWARPICHEM TOILE73 CA <br /> L7 TATT OO/BODY PIERCINe LAND USE,APPLICAnoNi SITES <br /> ❑MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> �_— WELL AND SEPTIC PERMIT RECORDS ARE AVAILA'xF FOR REVIEW- MONDAY-FRIDAY e:oo Am-S Ir M - EX.CLVOINO HOLIDAYS, R <br /> I. L"oat up b1 ten <br /> addresaea in the spsce above. Select the types)off flies from the Iiat above t y checking the -� <br /> appropriate ox 98 <br /> At least ono file typo MUST be selected. Fax to 200N3-013&or mail to the adclre <br /> indlcatod ah�aver. Address ranDEx1 will not bo accepted-for additional assistance with file addresses,contact. <br /> tho EHO.Appllcationr rocelveld after 3:00 prn will be Processed the next husiness day. <br /> 00 <br /> 2. The EHO wilt notify the applicant If any EHD files exist. An appointment.for review wilt ba confirmed <br /> approximately ten(10)days attar receipt of application. The files will be held for a maxirnum of five business <br /> d.aya for IeT fora. Appointmonts should be sf heduled accordingly. <br /> 3. A film thax is"-Uvaly being worked on by END staff may not be Irnmedlatoly available for review. A now <br /> application may be sHbmitted when the file is available. <br /> 4. Any file not returned In the same condition as released will be reorganl7ed by EHD staff at the expenue of the <br /> applicant f=uture file reviews by the same applicant may require a 893.00 deposit prior to review. <br /> EM 4re24W <br /> vent — <br />