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04126/2065 21:16 209369`8 ' <br /> STEPHEN G.MIJIR"~ PAGE 04/04 <br /> DATE RECER EE). I <br /> SAN JOAQM C0UNTY Etid Loc NUMBER <br /> EN"RONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3'd FXoor, Stockton, CA,95202-2708 <br /> Telephone: (209)468-3420 Fax, (209)464-0138 Web:wsvw.sjpv.org/eizd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 7: U/pe— <br /> ADDRESS: Z3 BUSINESS/AGENCY: <br /> PHONE(1): - 3ro ��` �/ U`�, <br /> TENTATIVE*APPOIMTiIENT DATE., �� b �' !� -FACSIMILE <br /> (Please*pow 10 buslrress days from dat of IiC9tion su Time: 27�/A d ` <br /> PID bmittai-'Tenfvd*e only•must be conflrmed) <br /> CHECK Box TO EXPMrrE REQ ST-$93.00 FEE(CASH OR CHECK ONLY) REQUEST PROCESSED IN 3 BUSrNFS$DAYS <br /> SIGNATURE OF APPLICANT (, , —c- , � <br /> DATE <br /> UNIT Di3T'RI13UTI4N p <br /> Unit 1 0 Unit 2 M Unit 3 13 Urift 4 p Unit 6 p Unit 6 p <br /> Other eieatmntc/fistslmsps) <br /> FILE ADDRESS <br /> Sheet Name EHd USE ONLY <br /> City <br /> , <br /> Sftha/E:fo,7 � <br /> 3. <br /> �` I Su we M <br /> 7. <br /> 1 <br /> Spedrtc Dat*Range of irtlbrmation Requested:From 4 411 Payr, fD C U e/-Cr <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES 1 <br /> p UNDERGROUND TANK(UST)CLEANUP SITE"P) n WOVSINOARATMMENr Ou <br /> SoeWAaTaFacILITY1VdIrcLE { <br /> I ?UNDERGROUND AN (MONI7oFUNCIREMOVAL p DOG FAGILfTY Ct WASTETiRE <br /> p HAZARDOUS WAvm GENERATOR KENNEL I O DAIRY <br /> p TIERED PERmTTTW FACILrrY In CNOXE:N RANCH Q WA$TEWATER TR€ATMENT PLANT <br /> p TATI'4O/BooY PIERcqG <br /> C MOTELl IOM -~I d PUMPER TRUCKIYAROICHEM TOILETS <br /> p PoouSaA <br /> p MEDICAL►iNABTE FACLLlTY °' Q LAND USE APPLICATION SITES } <br /> OThER(PLEASE SP=ryl I` <br /> WELL AND SEPM PERMIT RECORDS ARE AVAILABLE FOR REVIEW MONDAY-FRIDATB:DD AM-6:00Ply - Ek(,L` Up y WOUOAYS. <br /> 1. List up to ten addresses in the spam above. Select the types}of files from the list above by checking the <br /> appropriate box(es)- At least one file type MUST be selected. <br /> fax to 09 A 3"t o mail to tl�e addr s i <br /> indl above. Address ranges will not be - r <br /> opted- or additional asslsta"06 with file addresses,contact <br /> the EHD.Applications received after 3:00 pm will be processed the naxt business day. <br /> 2. The EHO Will notify the applicant if any EHD files exist. An appointment for review will be confirmed <br /> approximately ten(10)days after receipt of application. The files will 60 held for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly, i <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new <br /> applicat[On may be submitted when the file Is available. ,l <br /> 4, Any file not returned in the same condition as released will be reorganized by ENA staff at the expense of the <br /> applicant. Future file reviews by the same applicant may require a$93:00 deposit prior to review. <br /> . f <br /> J <br /> IIID�Q2-0ca . <br /> IMAM � <br /> ik <br /> s� <br />