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07/14/2008 14:35 . CLAYT LEASANTON 3 12094640138 _ NO.954 9001 <br /> 'ill W' '0*40", <br /> EHD LOG Nuh68ER <br /> E+NVMONMENTAL HEALTH DuARTMENT <br /> 304 East Weber Avenue,3Td Floor,Stockton,CA 95202-2708 <br /> LI Telepheonet(209)458-3420 Fax:(209)464-0138 Web:www.5jF,0v.or�e <br /> PUBLIC.�ECfJ <br /> ORD, <br /> REL AYS "PLICATION, <br /> APPLIMTAIIWL N o(t.1r1C.{ BUSINUS•S`IA(IENQY;&- VLr'iftj <br /> APPRE5s: { ly <br /> PHONE(2). '� �"� ACSIMILEcg_���2-��0)WO <br /> ENTATIVEkAlI3091Q WNTf)ATE:LkV oy Time: <br /> (Ploaca allow 10 nusina=days from data of•app9caj7- _ <br /> 6utsinittai-^7enfaLve only-muRY 4e eQnflrmed) <br /> CHECK BOY TO FxPEDITE REQUEST-$93.00.Pl=c(cp,SH OR.&HECK ONLY)-RE)QUEST PROMSSEp IN 3 BUSINESS oAVs <br /> SIGNATURE OF APPLICANT DATE '11tef t6 <br /> UNIT o15 rRIE unw d Unit 1 O URR 2 CIUnit 3 C Unit 4 0 Unit 5 O dolt c M Other(electrgnicnj%tWM ) <br /> FILE AMRESS 9HI3 USE ONLY <br /> street# Stregt Name Chy <br /> �. <br /> Z 1qV I r <br /> `I- <br /> 1 a�- <br /> e. L Ll zI <br /> 7• <br /> 8. 1 <br /> s. I <br /> Specific date lunge of Information Requested:Frohn to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> Ut4PW0ROUWTANK(UST)CLEANUPSTFE(LOP) ©Hou5mgABATEMENT SOUDWASTEF'PrATY <br /> 7NER CLLANUP SITE fN WLOP) Op FAClLfT' WAM 74RE <br /> A UN—GROUND TANK(M=170iRINGIREM0VAQ LJ D043 tiPNNIEL AAlRY <br /> XH=F1DQUSWASTF-GENERATORGNCKENRANCH iJ1Jgy �,ryyAYERTRBATlr1ENTPLANT <br /> ycgf7lCACdPERNIrn'EdFAGq.ITY t8FAMLJHaML jR3PUMPFiiTRUGrJYA.RDILI-!EMTOt <br /> y.TA77oo1BotrY FERC)No �00LISPA - ^4Ar10 USE ApPLlC,4T0N S[r�6 ! <br /> QI7`i„6DICAF W/4gTE FACJ4t7Y W()—R(PLEAS$SPMWY) <br /> WELL AND SEPric PEutTr RECORDS ARE A1fA1LAdLE FOH IZEI4EW- NLANPAY-FPjnAY 8.03 AMS:04PM - FXCLUAINS HOLIDAYS. <br /> [. 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 acne file type MUST be selected. Fax to{2091484-0938 or mail to tha addMss <br /> indicated above. Address rariges Will not be accepted—for additional assistance vl<M file addresses,contact <br /> the EHD.Applications received after 3.00 pro WIR be.processed the next business day. <br /> 2. The EHD Will notify the apprcant if any EHO files exist. An appointment for review will be confirmed <br /> approximately ten(10)days after receipt of applicatlon. The files will be held for a maximum of five business f <br /> days for review. Appointments should be scheduled accordingly, <br /> 3. A file that Is actively being worked on by EHD staff may not ba immediately available for review. A new <br /> application may be subMitted When the file Is available. <br /> I <br /> 4. Any file not returned pt tlTe same condition as released will be reorganized by EHD staff at the expense of the <br /> applicsnt. Future file reviews by the same Appricant may require a$93.00 deposit prlor to review. <br /> _ = <br /> v <br /> ENC 48.ffL009 - <br /> 'IN uuB <br />