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[� SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> [C� ENVIRONMENTAL HEALTH DEPARTMENT <br /> u i:.u ti, 2005 304 East Weber Avcnuc,3`'Floor,Stocldon,CA 95202-2708 <br /> Telephone:(209)468-3420 Fax: 209 464-0138 Web:www.s' ov. ehd <br /> E�fVIRONMENT HEALTIi ( � �$ °� <br /> pERNIMSERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPUCANT: ( CONSupwia <br /> Sk <br /> PHONE(1)_ LVD—i( '3 '�. � F 1MLE: .M (, <br /> TENTATIVE*APPWNTMENT DATE: TNne: <br /> (Plow allow 10 bualness days from data of appBcatiorr Submhtal-'Tirrrathe only-must be cwftn ed) <br /> ❑ CHECK BOX TO EXPEDITE RE QU •$93.00 FEE(C R CHECK ONLY)-REQUEST PROCESSED IN 3 SUSINESS DAYS <br /> SIGNATURE OF APPLICANT 091& DATE I <br /> ;4m IQr— <br /> uwTm?msvnoN 0 Unit 1 0 Unit 2 0 Unk 3 0 Unit A 0 UMt S 0 Unit s 0 other(e*obV iditfthRgn) <br /> .t FILE ADDRESS EHD USE ONLY <br /> tli<' sbnet it stem Nam. City <br /> a� 2. , <br /> 3- ,1�� <br /> s: r Dt- <br /> �Q <br /> 7. \�. <br /> a. <br /> 9. <br /> 10. �::• <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNosrinaouND TANK(UST)CLEANUP Sire(LOP) E3 HoustNa ABATEMENT O sous WASTE FActLrcriveHnLR <br /> OTHER CLU"SITE(NOME 13 POW FWAnY D WASTE TPE <br /> ( WWWRIM00 TAW(Il"VORINOAtE tOVAL) O Doe KENNEL D DAWtY <br /> .�HAZARIXPA WAST!GEE-BATOR 0 CHICI(W RANCH D wATTEWATER TREATMENT PLANT <br /> G TIMED PF.RWrrao FACKIN O MOTaLiHmL D PUMPER TRUCKIYArm/CHEM TO LUL <br /> []TATrooAkWY PERCH ❑PooL130A 0 LAND USE APPLl0ATION SnU <br /> 0 WNCAL WASTE FAMW 0 OTHER(PI.RAss SPECIFY) <br /> WILL AND SEPnc PEmrr RECORm Aril AvAM.Amz POR Ramw- MoNoAY4%DAY 8:00/w-5:Obm - EXcLunwe HOUCAM <br /> 1. List up to ten addresses In the space above. Seleot the type(s)of files from the fist above by cheddng the <br /> appropriate box(es). At least one file type MUST be selected. Fax to(2091454-0138 or moil to the address <br /> Indh aced above. Address ranges will not be accepted—for additional assistance with file eddresses,contact <br /> the EHD.Appaattlons received after 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD flies exist. An appointment for review will be confirmed <br /> approximately ten(10)days atter 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 EHO staff may not be immediately available for review. A new <br /> appliontion 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$23.00 deposit.prior to review. <br /> f <br /> t <br /> a P `. <br /> Elia�.we <br /> Zoo@ Qwimo %I2LLvxoaD TM COO OTS YV3 90:tT ZVS 20/ST/TT <br />