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1�0. 4yJ9 ; . c <br /> EHD LOG NUMBER <br /> May. 1B, 24Q� 9:52P Alva ed GeaEnviro�lnmental X <br /> DATE RECEIVED � SAN JOAQUIN COUNT , <br /> '� � D 1 EN'V�tONMENTAL HEALTH�EPART1ViiENT 708 h <br /> R E C E�1J E D Floor,Stockton, # <br /> CA 95202 2 <br /> 304 East Weber Avenue,3" 4'Sto $ VVeb•www.Sjgov.orglehd <br /> MAY 1 0 2006 Telephone: (209} <br /> 468-3420 Fay.- (zap) <br /> ENVIRONMENT HEALTH PUM]LYC nCORDS RELEASE APPLICATION <br /> P 60 gUSINESSIA000Y. <br /> APPLICANT._-sU h� lbQ ��� J� <br /> A00RESS: � FACSIMILE: Q ! - f <br /> p PHONE(2): O f 1Q01� <br /> PNONs:(t). � Ld► Time: <br /> st bG confirmed) <br /> TENTATIVE'APPOINWENT DATE: <br /> (please allow 10 business days from date of app, tion"bmitbl-"TBA QUEST pROGEg5 D IN 3 USIN SS DAYS <br /> E T-y�9.00 FEE[CA CH K ONLY) R <br /> CHECK EOX TO EXPEV4 E - DATE <br /> SIGNATURE Or APPLICANT <br /> ❑ Unit i Unit 2 13 Unit 3 <br /> D Unit4 i7 Units <br /> UMTDISTRWU116 ❑ 11nitB ❑ Other(electronlcllistslmaps) <br /> H FIE ADEHD USE ONLY <br /> E pRf=SS city <br /> Be4 street Name <br /> LIJ <br /> 0 If <br /> }b, <br /> 5. U <br /> &. C <br /> Specific Date Range of.information RegUested:From <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES❑��wA&TE FAc{LrrYlvE►s�cLr <br /> 't1 <br /> CLEANupaTe(LOP) L] FF011� AGIao $ATE�AENT 0WA$*TETIRE <br /> NpEA+�AOUHO TANK 01ST) ❑ ppp AC{L1TY <br /> THER CLEANUP 51TE(NO144.0P) C3 Doo KENNEL C2DAIRY <br /> U-ADERGROUNDTANK(IVIPNIT0Ft1NrdMM0YAL) ❑CHICKENRANGH ❑WASTEWASEFLTREATMENT PLANT <br /> A7ARDOUSWAETEGVHFRATOR 0 MOTELIHOTEL t3 PU9lEPERTRUCI`fYARDICHEmTOILETS <br /> ❑TIERED PEAFAITTED FACUTY C3 PUOUSPA ]S�LAND USE APPLICATION SITES <br /> *TAVrW80by PIC-FtC'M ❑MER(PLEASE SPECIFY) • <br /> ❑MEDICAL WASTE FACILITY <br /> WELL ANiJ$Ep'rIC PEFiEENT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM�:ODPM - EXCLU171NG H41.1oa <br /> -- List up to ten addresses in the space above. Select the typo(s)of dies from the lief above by checicing tits <br /> 1. x to(2091464-1)138 or mail to the address <br /> appropriate box(es). At least one Dvvlll not be accepted tyMUST be -foradditi <br /> ional assistance with file addresses,Mtact <br /> Indicated above. Address ranges <br /> the EHD.Applications receivedafter 3:00 pm will be processed the next business day. <br /> r review. The EHD will notify the applicant if any EHD files tion. The ist. An les vlril{bent fhold for a mWmum be confirmed <br /> ffive busir�w.s <br /> approximattaly ten(10)days after receipt of app <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 /> applications may be submitted when the file is available. <br /> 4. Any#tie not returned in the same condition as released will be reorganized by EMD staff at the expanse at the <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> l `'!i•;,1_' may.•••` <br /> END 4342-DN <br /> 1 �nslos <br /> r <br />