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06/03/2005 10:00 916-3709 RANEY GEOTECHNIS PAGE 02/0 <br /> p3 A <br /> (�M�"J�IJ 1/{� {� 1-1, G NUMBER <br /> lf�l) ED SAN JOAQUIN COUNTY <br /> ;# <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> JUN 0 3 7005 304 East Weber. Avenue,and Floor,Stockton,CA 95202-2708 <br /> EhfV(RCPthtENT HEALTH Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.oTg/ehd <br /> 17y,97), <br /> PERMIT/SERVICES // PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT• 0 C'L'✓i a IBUSINESSIAGENCY: e_ <br /> ADDRESS: <br /> PHONE(1): <br /> FACSIMILE, <br /> — PHONE(2): <br /> TENTATIVE"APPo1NTMENT DATE:_+LyI-9./'7aa5 Time: OG] <br /> (Please allow 10 business days from date f appOcallen submittal-'Tenfetive only-mast be wnnrmed) <br /> CHECK BOX TO EXPFOfTE REQ ST $93.00 FEE i9rASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUS NESS PAYS I a�9 <br /> SIGNATURE OF APPLICANT DATE <br /> UNIT OISTRIUUTION ❑ <br /> N1 06 nN 3 R4 O UnK S Unit E M other(electronlcAlstslmaps) <br /> FILE ADD — EHD USE ONLY <br /> StroolK afrpet Name City <br /> F <br /> .'_._..._.- <br /> -3. lSZB Ej. .151...-�.rivl¢.. . ..SFQ�(�•Ea,.. t45T . . . ..-, . . <br /> N.}F:..:. <br /> 5• . ..�.L��3 E N <br /> vv v s. 1 Z le�i o.... -- <br /> r <br /> 7. f D ! <br /> Fti. <br /> Specific Date Range of Information Requested:From 1 gqs to <br /> J/ ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> CIJ:INDFROROUNn TANK(U$T)CLEANUP SRE(LOP) 0 Houma ABATEMENT HSOLm WASTE FACUryN4HICLE <br /> PPPSSS� INV <br /> 7IER CLEANUP SRE(NON-LOP) 0FOOD FAca (WASTE TIRE <br /> K NR <br /> OERGROUND TANK(MOORINGIREMOYAL) M DOG KENNEL 13DNRT <br /> )HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH I7 WMTEWATER TREATMETIT PLANT <br /> IH-neRED"pMRTW FAGOT• 0 VOTEUHOTEL 0 PUMPER TRUCKIYARDICHEM TOILETS <br /> ❑TATTOOIBODY PIERCING O POOtISPA 1:3 LAND USE APPLICATION SITES <br /> 13 MEDICAL WASTE FAGHL O OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERAIR RECORDS ARE AYNLARLE FOR Rr~ - MONDAY4:RDAY 9:00 AM3:00PM _ EXCLUDING HOLIOAY0. <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(209)46"138 or mail to the address <br /> Indicated 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 next business day. <br /> 2. The EHD will notify the applicant If any EHD files exist. An appointment for review will be confirmed <br /> approximately ten(10)days after receipt of application. The flies will be held for a maximum of five business <br /> days for review. Appointments should he scheduled accordingly. <br /> 3. A file that Is actively being worked 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 /> END I5-02405 <br /> +nuas <br />