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frr�.a• 111_ML I11 rir :r <br /> bANJOAQUINCOUNTY L <br /> E' ONMNTAI.REALTIi bEPAJ,1"NT <br /> 1 \ <br /> 304 East Weber Avenue, 3"Floor, Stockton, CA.95202-2708 <br /> Telephone: (209)468-340 Tax: (209)464-0138 Web: I <br /> wwwsjgov.org/ehd <br /> _ PUBLIC RECORDS RELEASE APPLICATION <br /> ! APPLICANT' iCl< L <br /> f <br /> BUSINESSIAr_curv. ilhll. - ,�Atstitcr=ss; 3�10 W_ H - • •' .� - ssac. <br /> 1 ! til F Sia k 6 h CA <br /> PHoN6(t):EZa'i) 23N -7722 a+.a. 5 } .. <br /> ---- PHONE(2): tzll 14 9817-71 FACSIMILE: b 1 134 -7727 <br /> TENTATIVE,APPOINTMENT DATE: I o G <br /> (Please allow 10 business days from of appBgtion sut mhrai- Tentative on Time: 1 <br /> 1I CHECK BOX TO EXPEDITE only.must be con{ ed) <br /> C • J. F ( H OR CHECK ONLY)—REQUEST PROCESSED IN a BUSINESS DAYS <br /> 's• ' :"3:dATURE OF APPLICANT <br /> T _DATE . 11/22/o5 <br /> r 01STW9U77pN d unit 1 O Unit2 l7 Unit <br /> i Unit 4 ❑Untt 6 O Unit r 13 Other(etectron(dlistshmps) <br /> FILE ADDRESS <br /> 1. ZStre F Street name City EHD USE ONLY <br /> 2• 519$ un j cud �1u< w <br /> 3. 80 d �u T <br /> 4. 4 .J x N W <br /> b, 1 <br /> 9, <br /> 1.0 <br /> fic Date Range of Inform0i8on Requested: From II to <br /> 'yyy ENVIRONMENTAL HEALTH DEPARTMENT FIDS <br /> yL 0"06RGROURD TANK(UST)CLEAMP ISrrE(LOP) HOVSM AOATEMENT IQ So1.10 WASTE FACAM/VeNICLE <br /> 1I77FF//��OTHER CLEANUP Sm:(NoN•LOP) Few FAaLrn ❑WASTE Tote <br /> URryEP.GROUND TANK(MofGTm WREMOYAQ d Doo KEmm <br /> ` HAZARDOUS WASTE GERE ❑DAIRY <br /> ❑CTCKEN RANCH 0 WASTEWATER TREAYMENr PLANT <br /> TIEFFD PrRutMODY TED FACIITY d TEIUttpT61 ❑PUMPER TRUCK/YARDICNEM TOILETS <br /> KwT'ATR� BODY EFAc ry PCO fSPA ❑LAND USE APPI.K:ATION Sam <br /> ( OMfOt::AL WAS TE FACILtt7 ❑OTMER(PLEASE SPEciFY) <br /> . -. WELL AND SEPTI PERMR REcoRDs ARE AYARMLE FOR REVIEW. MONDAY-17MAY 8"00 AM-6;00PM - EXCLUDING HOLMAYS., <br /> t up to Eon addresses In the space above. Select the types) of files from the list above by checking the <br /> propriate box(es). At least one Tile type MUST be selected. Pax to (209)464-0138 or mail to the address <br /> Kited above. Address ranges will not be accepted-for additional assistanco with file addresses,contact; <br /> e EHD. Applications received after 3:00 pm witl be processed the next business day. <br /> EHD will notify the applicant if any EHD files exist An appointment for review will be confirmed <br /> I:ox`mately ten (10) days after receipt of application. The files will be held for a maximum of five buslnes <br /> z; s for review. Appointments should be scheduled accordingly. <br /> li'.c that Is actively being worked on by EHD Staff may not be Immediately available for review. A new <br /> FOC-atlon may be submitted when the file is available. <br /> .iy file not returned in the same condition as released will be reorganized by EHD staff at the expense of the <br /> ,{)piicant. Future file reviews by the same applicant may require a$93.00 deposit.prior to review. <br /> { <br />