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Nov 28 05 03.26p Apex is 2CSs7-9668 p.1 <br /> 7,E(2ECEIVED EHD LOGNUMBFR <br /> sax JoAtZunv COUNTY <br /> ENviRoNmNTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue,3d Floor,Stockton,CA 95202-2708 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd Z f <br /> fIT N:iE&TH <br /> RKES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Drew 4W I-tA BUSINESSIAGENCY: 411 <br /> ADDRESS: z-� IAjIL E73V t <br /> PHONE(f): PHO HE(2): FACS&1R.Ep <br /> TENTATIVE"APPOINTMENT DATE I Z f 'd)� T,,W- 7 <br /> (Please allow 16 business days from daft of application submittal-•Tentadve only-must be confinned)— <br /> CHECK aOX TO EXPEDITE REQUEST-$93.60 FEE JOASH OR CHECK ONLY)-REQUEST PROCESSED IN 3/g¢US17SS DAYS <br /> SIGNATURE OF APPLICANT Dfei^^V DATE ft/Z'tl4) <br /> dr/ <br /> UNrr DISTRmuTroN ❑Until OUnh2 OUnh3- UnR4 E3Urtlt5 0 Unit6 ❑ odw(elec7aYU7istcJmaps) <br /> FILE ADDRESS EHD USE ONLY <br /> stmtt0 slreetName city n, <br /> 5 ♦:A r+- ^ 14-n <br /> X12 <br /> 2 oQ t e.&+ L%44Si.+Llr. t act J <br /> fLS S . e r+r 4 5L Z 9 <br /> IV . al to s <br /> 5. d3 p tK n <br /> 6. (&Los 1.' . rA,o. • u 4^ 3Sal JD /a9 o^r <br /> 7. >`13t v 4 A- ,F-, <br /> 8. <br /> . 3V1 3. 6t r 11 t t a <br /> 10. Doftkn <br /> Specific Date Range of Information Requested:From Z.-UQ,f'L to (Tf f•IPt,4 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 1t1lNDMWWUWTANK(UST)CLeA wSrE(LAP) OHcU wAs&TemENT 1!3$ DWASTEFACa IVWIcLE <br /> O OTNERCLEANDP SrrE(Ncv4-OP) ❑Folio FAcuTY E3 WASTE TWE <br /> 17 UNDEPrdMUNDTANK(MoNnomNc4REmWAL) ❑DOG Ka, u E3 vmy <br /> 13 HAZARDOUS WASTE GENERATOR ❑CrfCKENRANCH E3 WASTEwATeR TREATMENT PLAw <br /> ❑TWEM PER ITTEn FAOUTY 0 MDTELIHOTEL 13 PUMPER TRvcKrfARv1C" M TmLErs <br /> 7ATTDOJ30EY PF-WNG IM POOLISPA 0 LAND USE APPLJCAnON SRL, <br /> ❑MENCAL WASTE FA=JTY O OTHM(PLEASE SPECIFY) - <br /> WELL AND SEP=PERM T RECOms ARE AVAILARtE FOR RE EW- MONDAY-FRIDAY 8:00 AM.S:OOPM - FXCLUDING 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 (209)464-0138 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 files will be held for a maximum of five 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 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 /> ERD O=ats <br /> •ufats <br />