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RECEliVED <br /> E , NmNTAL HEALTH DEPART, NI T <br /> 0 Weber Ave P Floor Stockton,CA 9; <br /> APR 0 6 20$09)468-3420 Fax: (209)464-0138 Web:www.co.san-joaquin.ca.US/ehd <br /> ENVIRONMENT HEHLI-H <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION - <br /> APPLICANT: � S N R R yn h-V BUSINESSIAGENCY: <br /> ADDRESS: 3 SSy <br /> PHONE: !;�10, $6-1^e31F zI —FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal) <br /> 13 CHECK BOX TO EXPEDITE REQUEST- 9 E RE SSED W 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT - DATE d <br /> Departrnent Use Only <br /> Fik ADDRESS UNIT <br /> 4- sbeet 9, W, atyfi1R.A c-. po011nit 1 ' <br /> i. skeet CRYr <br /> 3. Sbeet city OW Unit 2 <br /> a. Sb.et <br /> S. Skeet .� �hy) <br /> 6. Sb" luy <br /> 7. sheet city <br /> 6. Suet CRY <br /> 0• Street M Unit 5 <br /> 10. sued city <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> OUNO <br /> ;UE' <br /> 0 OUSIN13 ABATEMENT 0 SOLID WASTE FACILITY <br /> NONa.OP) FOOD FACILITY0 SOLID WASTE VEHICLE <br /> (M0 DOG KENNEL 0 DAIRY <br /> ENERATOR 0 CHICKEN RANCH 0 PKG TREATMENT PLANT <br /> 0 TIERED PER1tITTTED FACILITY 0 MOTELIHOTEL 0 PUMPER TRUCKIYARDICHEM TOILETS <br /> 0 TATTOOIBODY PIERCING 0 POOUSPA LAND USE APPLICATION SITES <br /> O MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPEC" <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above¢y checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the <br /> address indicated above. <br /> 2. EHD will notify the applicant if any EHO files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten(10)days after receipt of application. The files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> 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 <br /> of the applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> 5. 'TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> C�Ni .RMEO ', iNTMAN ' ATIME <br /> y r..�.•r p• avJ c:: Y. -z.: <br /> PHONE <br /> Et1llEVlf)~D ;:. TIES NO REVIEW GATE' ' : . =< :• " <br /> ' trrw atio:-eas , <br /> ilil20tt3 <br />