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SAN J<OAQUIN COUNTY <br /> RECE V ED ENVIRONWNTAL REA.LTH DEPARTMENT <br /> 304 East Reber Avenue. 34 Floor,Stockton,CA 95202.2708 <br /> JUL ", 2005 Teiepbobe-,(2469)468-3420 Fax:(209)464-0118 Web:W-A w.sjgOV-0464 <br /> ENVIRON ENIH EALTpuBI,IC RECOM RELEASE APPLICATION <br /> r[w Scwa gU3U1ESgJAO@NCY -�tt��— <br /> AP�u`ciutT:-,.. ---�-� d14S4 1 __. <br /> ADOREsS:_l$�� 8 S�eeef• I.l ,.�w C .� <br /> PNor�pr,S(�"�u7'haBS *sea PtwNe(21:_�lLg - 534 -51LA FACSOPLE: <br /> TENTATNE•APPaNTM-M PATE: Timr: �� <br /> (Pleats allow 10 Wwlness days hon au of tpMl UW 7ubmlbAi•@1006tive onM-must be confim�ed <br /> XNA <br /> t1ECK LOX TO WEDITL REQUEST•Lt3.00 P R(CASH Orf CHECK ONLY)-REQUEST PRCG 83FO IN 3 SUS S81RE OF APPLICANT - DATE <br /> UNIT bL1TRILt/110N ❑11nrt 1 0 UM I n a 3G4 ❑ura L O Usk t O Pen"(Necd'a10Utsfm") <br /> FILE ADDRESS EHD USE ONLY <br /> steam Noma — _ 0fl�(S <br /> ON <br /> �U.S x:, W <br /> 3. W I S1 W <br /> 7. rVu <br /> y - <br /> V - <br /> t,ssttk-:� ta. �--- <br /> ' Speaft Date Range of Information Requeated:From <br /> ENVIRONMFN HEALTH DEPARTMENT FILES <br /> I.;.0,t1NOWWRO MO TAW Onn CL"Our&TE NODI �1a,�1tW eHr ❑SOUD WASTE FAcrm1V&0= <br /> til R O-e~sae(N004.OP) ., r.curr 0 WASTE TW <br /> 12 MOKKOROUMV <br /> r wunatrseaArOA !:g <br /> : CMcrcuacN boo 0a wwsTewAteKTUArrtw Para <br /> TisAw PUutamr&FAcww '� - ❑tbTM10T[L 0 PuYPeq Tm"0m /Crier Trim <br /> n TAT'rOO16fNW Ptxcaa �y...:2fi rn Pow-'spA 0 LAM USE APftXAn0N STaa <br /> Q Nrelcal WASTE Abu 36 ... a On"( *V-brccrT) <br /> Well ale ae+Tk Papel alta Avna.AauE FOR RXvagY- tWgAv-FaioAv t:te Ard:oaw . Fxcumla0 iktpA}'S. <br /> 1. List up to ten addressee in the space■bove. select the type(s)of files from the fist above by chocking the <br /> appropriate boX(as). At Nast one Me type MUST be selected. Pax to(1091 0138 or m�510 the addrosx <br /> (pdic&ted above. Address ranges will not be accepted-for additional assistance With file addresses,contact <br /> the EHO.Applications reooiYed after 3100 Pm will be processed the next business day. <br /> 2. The EHD VM nof7ty the applicant if any EHD files etd,t. An appointment for review will be eonflenved <br /> approximately ten(10)days after receipt of application, The files VIII be held for a maxlmum of fire business <br /> days for review. Appointments should be scheduled accordingly, <br /> 3. A file that Is actively being worked on by EHD staff may not be immediately available for review. A now <br /> application May be submitted when the fila is avallabio. it <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the expense of the <br /> appgcanl. Future file reviews by the same apphlesnt may require a E93.00 deposit prior to review. <br /> 1�.9ftia <br /> S9 39Vd -1d1N3WN0NIAN3 SVa3 66£S98BOTS ST :£T S09L/6T/L9 <br />