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01/08/2007 08:42 FAX <br /> (�002/002 <br /> 11/ $ I-0 �'S1\/4/ 60138 Y ENVIRONfENTAL H1 r uz <br /> 1 " IJ 1J (��� SAN J OA,QLIXN COUNTI' � EHD LOG NUMBER <br /> 7 5 t 7,�J El,_.IRONMXNTAL REALTAg DEPA�sVTENT <br /> ,�.y 7.007 304 est Weber Avenue, 3`d Floor, Stockton, CA 95202-2708 qq <br /> ���� ENVIRONKlENT HALTHhDDe;(209)466.3420 Fax:(209)40]38 Web:www.sjgov.org/ePERMIT/SERVICES PUBLIC RECORDS RELEASE APPLI 7 <br /> CATION <br /> APPLICANT: Ito <br /> ADDRESS: OU6INESSIAGENCY: <br /> r c n 20S' <br /> PHONE(t): PHONE(2): . <br /> FACSIMILE,- <br /> TEHT'ATNE•pPPOwTMENraATE: )I S— ems'• <br /> (Plasm allow 10 business days <br /> tram Rate f appf Time: <br /> r only nxut be 4 CHECK ItpX 1v 2XPEDRE Rfic1uE9T-$95.00 FEE(c TanMWe on <br /> "REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT <br /> DATE <br /> Efectronic Infortnation: EJ List❑MapAption: <br /> sb,retR . FILEANat" EHD USE ONLY <br /> Simi;N.une <br /> • �. tH Cay 4 Unit t <br /> 8. 3DO drat z <br /> 4. r ft <br /> 5. <br /> 6. Ur*4 <br /> d. ❑ Unit s <br /> 9, <br /> 1 a, umi e <br /> Specific Data Range of Information Requeafed..From (/ o <br /> ENVIRO.MENTAL HEALTH DEPARTMENT FILE$ <br /> NOTANK NST)Q-WWP Snit(LOP) O Hous m ARATmorrWAST:FACa.mlYEfacLE <br /> OttIER La?ANUP SM(Htw1oF) O FOOD PAcanY ASTE TEtE <br /> URD19tGROUND TAW(MONROfaNQPAIOVAL) ❑Doc 1<004a. <br /> KAZAk0 US WASTE GENERATOR O CH CKEN RANCH TERA&TGaY ABrENATaiTILAtMIT PLANT' <br /> n ATTootWwj=IPMER TRUCKIYAtDNhffiM TonE <br /> ra <br /> &IMCAL AI7E FACLRY O POOLISPA LAND USE APPuCATOsnu <br /> ❑OIHIR(PLEASE SPECIFYI <br /> WELL AND SW=PMMT RECM3 ARE A.VAXAMU!FOR REVEW- McNoAYr-RaAT <br /> 8.'00 AMv:00PM t:x0.uo04e HOI.gAY3. <br /> !, Ust up to ten addrasses In the space above. Select the type(A) <br /> of fifes from the list above by cheddng the approprfato <br /> box(es). AS toast one file <br /> type MUST be selected. Fax to(209) Address <br /> nr mail to the addrg�s Indlcaled above Address <br /> `ranges will not bo acCepted—for additional essistanca with file addresses,contact the END.Applicatlons receivad after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant If any EHD files exh:L An appoltttimat for review wIll be confirmed approximately ton(10) <br /> days after reealpt of application. The files will be field for a maximum Ot live business days for review, AppoinimontS <br /> should be scheduled accordingly. <br /> 3. A file that Is actively being worked on by EHD staff may not ba immediately available for review, A now application may be <br /> submitted when the f io Is available. <br /> 4. Any file not returned in the mama condition as released will be reorganized by EHD staff at the expense of the npplioant. <br /> Future file revlaws by the same applicsnt may require a$95.00 deposit prior to review., <br /> END USE ONLY <br /> @P IB-0s st1ZaOC <br />