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Sap-20-07 04:20pm From-ENVIRON +5106559517 T-430 P.02/02 F-008 <br /> r_nV I.W NUIV46".I♦ <br /> PATE <br /> MMURSEED SAN JOAQunv COUNTY <br /> ENVIRONMENTAL MALTB DEPAP-TMEN <br /> S�.P LO (0 East Main Street,Stockton,CA 95202-3023j431t5 elephone: 209 468-3420 Fax: (209)464-0138 Web:www. <br /> ENVIRONMENT HEAET�UBLIC RECORDS RELEASE APPLICATION <br /> PERM EIJV1ROK <br /> APPLICANT: Sin _Y-Qv) jj/I Iii/ Vi(�(���Ak, _ BUSINESSIAGENCY: <br /> ADDRESS: <br /> AlejkMoi.kkIA _ <br /> PHONE(1): PHONE(2)= 11 A( <br /> TENTATIVE`APP04NTMENT DATE: n f1k-0 b�`�12�0 ( o y � ►o, a,t,� c�(„�� <br /> (Pleaso allow 10 busin"s days from date of appNeation submittal- Tentativo ony•must be eonfirnled} <br /> C3 CHECK BOX TO evEDITE REQUEST•$98.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 1120 �-00'�- <br /> Elactronlc information: List❑Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> g >T Street Name Cit ❑ unit 1 <br /> 2. a� <br /> t u Vl r- ❑ Unit Z <br /> 3. Unit 3 <br /> S. <br /> 7. ❑ unit s <br /> 8. <br /> 10. <br /> Specific Date Range of Information Requested:From �u c' V,ot.d t to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FFIIL�E"S <br /> E <br /> ND TANK(V$n CLEANUP SITE(LOP) Q I-Imma ABATEMENT Lip WASTEFA=M/VEHICLE <br /> mup suE(NON-L.OP) 13 FOOD FACILITY WASTE TIRE <br /> ND TANK(MowroRnNWREmOVAL) C1 DOG KENNEL C7 DAIRY <br /> WASTE GENERATOR E3 CHICKEN RANCH AM-eWATER TREATMENT PLANT <br /> TIERED PERAnTrEo FACILITY 0 MOTMiNMEI PUIYpER TRUCKlYARDICNE6I TotLETS <br /> O TATTOOMODY PIERCING I3 pooLWA ,.1 M'A <br /> n 9E AF1'61CA BITES, <br /> O MEDICAL WASTE FACILITY YOTNER(PLEASE SPECIFY) WIM QN l 1��r�VW� <br /> WELL AND SEIMC PERMrr RECORDS ARE AVAILABLE FOR REvlrw-MONDAY-FRIDAY 8:00 AM-5:00PM - EXCI-VOM 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 appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)460139 or mail to the address Indicated above Address <br /> ranges will not be accepted—for additional assistance with file addresses,contact the EHD.Applications received after <br /> 3:00 pm will be prboessed the next business day. <br /> 2. The EHD will notify the applicant if any EHD files exist. An appointment for review will he confirmed Approximately ten(10) <br /> --- days-after-m-,eipt-of-appileagon.-Theles-willbe-held-for-a-maximum-0f-ixebusiness-days-for review. _ApVotdbMRnta._ <br /> should be scheduled accordingly. _ <br /> 3. A file that is actively being worked on by FHD staff may not be immediately available for review. A new application may De <br /> submitted when the file is available_ <br /> 4. Any file not retumed in the same condition as released will be reorganized by EHD staff at the expense of the applicant <br /> Future file reviews by the same applicant may require a$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> 41.61 WEB T <br />