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1b:29 2096342883 FEDEXKINKOS PAGE 02/02 <br /> DATE RECEIVED EHD L0C3 NUMSER <br /> ((��fT�E � SAN JOAQUIN COUNTY � <br /> Ln]LS f 0 v D 3 �NvmOrr ;NTAL HEALTH[DFTARThMNT <br /> 04 East Weber Avenue,P Floor,Stochm CA 95202-2708 <br /> F-ER 1 5 ,905 WckpbOft:(209)468-3420 Fax.(209)464-0138 Web:www,sjgov.org/ehd <br /> ENV1RnNVT,�T NE,.I TN PUBLIC RECORDS RELEASE"PLICATION �- --- <br /> �} BUSlN635fAGs>?11CY^__ �(�X (`,NViJO+tC <br /> ADDRESS: Lwf c f rl4CK C4 <br /> PH0fm(t)-'3L(rs 7J-T"- 6o74 PtIONE(2):_ GII)o tYoCO FACMfLE: <br /> TENTATIVE"APPoiNTL:aEwY78 <br /> (ase aPow is bmirms days*=*it��cppucvb subm tw-*ro�tivetb <br /> orliy-moat be cwrTv� <br /> CHECK BOX TO EXPEWTB REQUEST.t$03.00 F't*E,(CASH OR CHECK ONLY)-REQUEST PROCESSED W E B"NESS DAYS <br /> SIGNATURE OF APPUCANT _h.-1w.\_A V�_ DATE TJ(,)j<�'r <br /> uNrr DisTRlstn>ore U that 1 0 Usrtt 2 D WK 3 0"4 D Ur&S OWNS D Otfrer( ap;yt ) <br /> FILE ADDRESS END USE ONLY <br /> Straot p sb*et Nam City <br /> 1. t s^�L� i� Sl. ,n 4:< `T-b) <br /> 8. <br /> Speditc Date Range tNInfbrwruocR,Rcqumtod:Front to <br /> ENVIRONMENTAL HEALTH DEPARTMENT Ftf ES <br /> *0MOROUND TANK MST)CLEANUPSRE(LOP) Q Hamm AmTsew 0 SOLD WASTE FAC"YA&MM4 <br /> 13 OTHER CLEANUP SRL 010N.LOP) 0 Food FACNrr 0 WASTE TIRE <br /> 13 WKWAOROUNDTANK(MMT0RMfl'EMOVAL) 13 OW KWOL 0 DAIRY <br /> r]HAZARmua WASTE cSWxATO R 0 Cmumm RArm 13 WASTEWATER TYRFATMM PLANT <br /> 0 TIERED PERIfMm FACk" 0 fsoTmAlotEL 0 PUsWER TkMdYARarCHM TOHZM <br /> 0 TATTOONOW Primo A POOUSPA 0 LAND Uw Appumnm SrrEs <br /> 0 MEDIcAL_WAsTE FAc H rrY El OTHDL(PLUM SPegRY) <br /> VAiLL Atm Sspne PEWff RI3oROd ARE AVAUMLE FDR REm-W- MONDAY.FWDAY 8:00 AN.GMp a - ExCt WM HWMYs. <br /> 1. List up to ten addresses in the spqm above. Select the type(s)of files from the list above by checking the <br /> apprapHate bax(68). At lamt one file type MUST be selected. Fax to l2091 464-013S or mail to the address <br /> Indicated above. Address ranges will not be accepted--for additionall assistance with file addresses,cohtact <br /> the EHE),Applications recehled atter 3:00 pm will be prooessed the next business day. <br /> 2. The END will notify the q*icatnt if any EHD filers exist. An appointment for mviaw will be c oofirtTmd <br /> apprOXimhatelY ten(10)days af'tw receipt of application. The files will be held for a maximum of five business <br /> days for review. Appointments should be scheduled eccordingly. <br /> 3. A file that is=tivefy being vrorked on by EHE)staff may not be immediately available for review. A new <br /> appllcation may be submitted when the file Is avaliable. <br /> 4. Any file not ret tined in the same condition as released will be reorganized by END stsaff at the expense Of the <br /> applicant. Future file reviews by the same appliant May require a$93.00 deposit prior to reviser. <br /> I <br /> ---- {{� <br /> Erw se-ozone f <br /> Lrwna <br />