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08/27/2006 10:58 FAX X042 <br /> EHD LQQ NUM BF-13 <br /> GATE RECErVED SAN JOAQUIN COU TY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue,Yd)Floor,Stockton,CA 95202-2745 <br /> Telephone.(209)468-3420 Fix:(204)454-0138 Web:wvrw.sjgov.0rg1ehd <br /> I PUBLIC RECORDS RELEASE APPLICATION <br />` �.y �1 .. ISG susINE55lACnENGY: lils,f ���+ �h�w-_ <br />€: APPLICANT: <br /> 5 AnEaRess: �1 dl q _ <br /> 'f. PHONE 1 3y° 7. PHONE M FAC1a41L1=: <br /> TENTATIVE;APPOINTMENT DATE: Time: — — <br /> (Pime allow 10 basins days from dale of application subittittal-Tentative only.-must be eonimrad) <br /> GHEGK BOX TO EXPEDITER U -893.00 P (C R HECK ONLY).REQUEST PROCESSED IN 3 sUSINES ,DAYS <br /> SIGNATURE OF APPL'CANT DATE 1 o <br /> UNITDESTRff6UTEOIV ❑Unit 0 0 Un9t Unita 0 Unit 0 Units Unite ❑ Otlter(elkironlcdllsIns/mapa) <br /> U141T JIISTFUEI�� <br /> FILE ADDRESS _. EHD USE ONLY � <br /> . .....w .._._.— �L... . __ <br /> Street� 5tnaef.Name <br />' 'l• "��� ��1�1,4l�, [..Af � � *•S►�'O.d.XYO++f ------ <br />� - <br /> 4. 11012 <br /> ..f'Z.1 A .&RO& . <br /> V, <br /> Specific Date Range of Informa.pon Requested:Front t0 ` <br /> E ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 4 UNOERGROVNQ TANK(USTI CLEANUP SITE(LOP) Q HOMING ABATEMENT 0 SOEJO WAM FACILITYM-FICL.E <br /> "Till CLEANUP SME(NON-LOP) E3 POW FACILITY ❑WASTE TIRE <br /> UIWMGMUND'tANK(IAOWrOMNGIPE OVAL) E3 DoeKmNEL. CI DAIRY <br /> HALAROOUR WASTE GENERA-MR Q CHICKEN RANCH ❑WASTF-wATERTRZATMENT PLANT <br /> Q_nERED PERIOTIED FACIEm E3 MO'EELIMOTEL ❑PUMPI:RTRUCrJYARVCHW TOILETS <br /> ❑TATYOOl94CY PIERCING =POCLISF'A 13 LANE!USE AppucATtax tSnEs <br /> ©Mr:01CAL WASTE FACILITY 0 OTMM{PLEASE SPECIM <br /> YNELL AND so tic Puwrr RECORDS ARE AVAILABLE FOR RLMEW. 11110mDAY•FRIOAY 8:04 AAd4:04FM - MoLtiyirio Hcut9AY$. <br /> 7. Ust up to ten addresses in the apsoe above. Select the type(s)of files from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax to(209)464.11138 or nail to the address <br /> Indicated above. Address rangrn Will not be accepted—for additional assistance with file addresses,contact <br /> the EHD.Application~received after 3:00 pm Will be processed the next businew day. <br /> 2. The EHD will notify the applicant if any EHD files&)fist. An appointment for review will he confirmed <br /> I upproxink tely ten(10)days after receipt of application. The file$will be hold.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 /> sppllcadon may be submitted when the file Is available. <br /> 4. Any File not returned in the same condition as releaead Will be reorganized by EHD staff at the Expense of the <br /> sp}slicant Future file reviews by the same applicant trayrequire L1$93.00 deposit prior to review. <br /> .5 <br /> EEG IF"24 H <br /> IM4'OB <br />