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07/31/2006 11:05 CLAYTON PLEASANTON 4 12094640138 <br /> W.217 [7001 <br /> 14m� EHD LOG NUMBER <br /> D SAN JOAQM COUNTY <br /> ENNTROmvMN'TAL HEALTH DEPART'MNT <br /> 304 Fast Wcber Avenue,3rd Floor,Stockton,CA 95202-2708 <br /> 2006 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www-sjgov.org/ehl <br /> ENVIRONMENT HEALTH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> A.PPLY'ANT. Pi l 1 C- 1�(a, UUSINESWAGENCY: <br /> ADC RESS: <br /> PHow(1). .a 7 PHONE(2):�r <br /> TE=NTATIVE'APPOgNTMENT DATE_- & , 1 2mo� _Tuna: & ,1 • <br /> (Pleaas allow 10 tiatsin�q days from dot f applicdtion submittal-*Tenfetiv'e only-Must be eonit wod) <br /> i7 CHECK UOX 70 EXPEDITE REQUE T-b .00 FEE(CASH OR CHECK ONLY)-REQUEST P-ROCESSED IN I BUSINESS LAYS <br /> SIGNATURE OFAPPLICANT A' DATE <br /> UN,rr D1STmuu- oN C3 Unit 1 0 Unit 2 Unit 8 d Unit 6 Q Unit 6 other(ol tctronicfflatafmaps) <br /> FILE ADDRESS EKD USE ONLY <br /> StraRt d street Naffm city -- <br /> 4._ (tri - ---- <br /> 27. <br /> ID.L ._ <br /> Specific Dais Rare of Infomialkn Requested:Froin :�La03 to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ITi 11jmMR0uND TAm-,(UST)QxAwtF �(LOP) ❑Haysm ABAmmEmT ❑SWO VVAs7E rAai_rrjNEWLE <br /> O'THGft tiLF13NL`P StiE(NON-EQP) <br /> ❑FOOD FACILITY 0 WASm Tim <br /> lir U[110rr7tQFd:oum TANS (MONITOMMGMUKW.AII) ❑DOG KENrN R. Q DAIRY <br /> W HAZARDOUS WASTE GENERATOR ❑CHIUMN RANCH 1•s WAsrE`NATFRTI3EAMENT PLANT <br /> 9 TIERED PERWTED FACTUTY 0 MOTELIHOTEL 0 Pumf-R'rFmc NAFai!CmEm TDfL¢:rs <br /> ❑TATTOOMODY PIERCING ©POOLISPA ❑LAND UsE APPLICATIOm Nares <br /> 0 MZMaAL WASTE FACIutY El OTHER(PLEASE 5K4 FY) _.. - <br /> WELLAND 5JnCPERMIT P-CORDS ARM NVAnABL.rr.FOR REVIEW- UIONDAY-FRIDAY 8:00AW&0'2m - ECCiuDINoHOLIDAYS. <br /> 1. list rap to ten addres.es in the space above. Select the type(s)of files from the list above by checking the <br /> rtppropriate box(es). At least one file type MUST be selected. FM to(209)464-0938 or mail to tha address <br /> Indicated above. Address ranges will not be accepted-for additional assistance with file addr ses,cvrntau! <br /> the EHD.Applications received after 3:00 pm will be processed the next business day, <br /> 2. T'ho EHL)vnrill notify the applicant if any EHD fifes exist. An appointment for revlaw will LW confirmed <br /> approximately ten(10)days after receipt of application. The files vdil be held for a maximur-i of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that is,actively being workod on by EHD staff may not be immediately available for review. A neva <br /> application may be submWedl when the file is available. <br /> 4,. Any file not ratumed in, the some condition as released will be reorganized by EHD staff at 6e pfenst:of the <br /> gpplicarit future file reviews,by the same applicant may require a$93.00 deposit prior to rovlew. -` <br /> Ergo 4�a:.ams —� <br /> uawm: <br />