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MRR 11 2005 9: 34AM LASERJET 3200 p• 2 _ <br /> LIATERECEIVED ENVIRONMENTAL r,,LTH <br /> SAN JOAQUIN tnU LLAT COUNTY LVe01 <br /> NUMOtK <br /> ENV(RONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3rd Floor, Stockton,CA 95202-2708 / <br /> Tclepboaa(209)466-3420 Fax:(209) 464-0138 Web.www.ajgov.org/ehd (iQ <br /> 2005 MA PUBLIC RECORDS RELEASE APPLICATION <br /> APPUCANT. <br /> SAH JCA66 C SINESWAGENCY: <br /> ENVIRO u0 L-5� <br /> HEAL?1#0 iA ^�I^� 1 — ryT —0/7�� <br /> ---�_. PHONE(2): dV — ACSIMILE: �U`7 <br /> TENTATIVE'APPOINTMENT DATE: <br /> (Pleas taoW 10 buarnoaa Jaya morn Cate of apoll"a"on aubmkw-• rune: <br /> M1nfaNYe ony.mwt be corrfirmedl <br /> CHECK BOX To ExPEDITE REO EST-ta7.00 FEE( H OR C ECK ORL <br /> SIGNATURE OF APPLICANT(_ n REQUEST PROCESSED IN J BUSIN69S OAYS <br /> DATE 2-16 <br /> UNIT DISTRBUTION -❑ Unll t Unk 2 C L411 3 ❑ Un't e ❑ Unit 6 ❑ Urul6 C Other(slaclronIcMSWmaps) <br /> FILE ADDRESS <br /> Streets stnH Wmk ciry EHD USE ONLY I7 <br /> 2. <br /> 3. <br /> 4. <br /> 5. <br /> 6. <br /> 7. _ <br /> 9. <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FIDS <br /> ❑014FR CLO NOTANK(UST)CLEANUPSITE(LDP) ❑HOUNINO FAcimyEMEM 1 OLID WASTE FACRITI'NaNIC1.E <br /> l0 OTHER C*0A -SITE"K (HON-LOP) ❑F000 KENNEL <br /> ❑WASTE n+Ra ` <br /> �liTlOckOkOUIO TANK(MOMn'ORWDIREMOYALI ❑Doo KENNEL g DAa3Y lrlL <br /> HAZARDOUS WASTE GENERATOR OQRCKEN RANCH ASTEWArERTRSATMDR PUNT <br /> 13 TIERED PEm/Socy PIR el mILnY O MMElI140TEL ❑PUMPER TAUCK/YARD/CmN TOILETS .+' <br /> s# <br /> O T MEDICAL <br /> A3 PIeRCU ❑POOL/SPA �i LAND USE APPLICATION STrES l)1LJY+J- <br /> O MEDgAI WASTE fACRJ1Y D OTHER(PLEASE SPECRYI <br /> WELL ANO 30P PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY,FAtDAY 6:00 Aa-S:DOw - EXCLUOINC 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(2091464.0136 of mail to the address Win' <br /> indicated above. Address ranges will not be accepted—for additions]assistance with file addresses,contact <br /> the EHD.Applications received after 3-,DO pm will be processed the next business day. <br /> 2. The END will notify the applicant If any END 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 samo condition as released will be reorganized by EHD staff at the expense of the <br /> applicant. Future fila reviews by the same applicant may require a$93.00 deposit prior to review. <br /> END 44 01 <br /> ,+RS9I <br /> FILE COPY <br />