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Aug 25 05 04:50p Nissa Nack <br />925-+014-1942 p.1 <br />r°AEHD LOQ' NLMI3F:' i SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />5 2006 304 East Weber Avenue, 3'a Floor, Stockton, CA 45202-2709 <br />Telepbone: (209) 468-3420 Fax: (209)464-01381Meb: wvrw•.sjgov.oTglehd <br />ENVIRONMENT HEALTH <br />PERMIT/SERVI PUBLIC RECORDS RELEASE APPLICA ION <br />APP'JC:`AM: �,y: 1_7 Pek_ f?USIHE551AGENC'P:—_I�A( <br />aDD SE ss: � : `2? D 1"i_a -1 (r�� 1 r P v�H �i e. sa��b� - ITTq •r <br />` FACSIRLE: <br />PI�N)NE (tl:l r.°'��'~+I 1 �7"1,_K i� ^—PHONE I=4: <br />377h- <br />fe <br />TEWTA7R9E' APPoe1TMEtn'DATE Time: _ <br />fFlease allow 1n basiness tlays fiooll dafa of appFcation subminal-'renfado! only -must <br />M CHECK. EYJX TO E)PEDITF`. REALEST- (CASHOR CCK ONL'n - FIEQIJi:ST PROCESSED IN 3 SUSINESS DAYS <br />SIGNATURE OF: APPLK.00fT �G��` .ice. --- DATE <br />UNrt OISTRi77FM ❑ UnttI a" Unit O Unita <br />O Unita C1 Unit6 <br />C3 UOlt6 17 other=(E(f304*nnWAiShJMMP3l__ <br />�• <br />FF91_E ADDRESS <br />EHD USE ONLY <br />Stred;f street lWme <br />City <br />—_ <br />•l. ao cT— <br />-- <br />zE <br />pnb <br />VE- — - <br />4._C2Z$ �1` ._ a <br />— <br />S.3- <br />7. turLA <br />S � _ J <br />! n <br /><— — <br />L <br />('k <br />spEolila rmie Itfi nge of Imarimmor Fte triested. <br />UN111RONMENTAL HEALTH DEPARTMENT F' FS �— �7Er ' B ZO06 <br />'POERGR]UND <br />TANK (UST) Srm{LnP) CI Hou%NG ABATEMENT ❑ SOLM WASTE FACIL�I fVEI.ICLF. <br />�CRHIER CLEANrA>SITE (N:NH!7P) C FOOD FACT O WAAAETIRE <br />OUr41EROROMe 7Arat(MCNn OWHOMENWAL) CI DOG KENNEL MDAIRY <br />-0F"AzAR4Wlav%s TE GERERATO(t 0CNICKENRANCH 0 Wl:TEWATER TPEATMENT PLANT <br />E5•TIFJifD Pra1MI'n"_D FACE." C.I MOTELIHOTEL 0 PUarm Tw aKrY FnicHE a TOILETS <br />11 TAr'OC 4w PIETInluG CI POOUSPA 0 LAIO USE A°PIJ.ATIOH 516 <br />CJ AIEVICALWASTIE FALILM CI OTHEr:(PL SESPECIFJ_ <br />VIELLA140 SEFMC- PERfAV' Recooln ARE AVANAe1_E FOn Rte -.VIEW - MOImAY-FRIDAY e:BG AY•FiN1FM—�E%CUIIIINO HtLIDA.YR. <br />.l. List up to len addresses In the Space above. Select the type(s) of files from tITE! list above by check!rty the <br />appropriate box(es), At least one. file type MUST be selected. Fac to (209�f 0136 or mail to the address <br />indiea>)Eng tone. AddresR ranges w01 not be accepted —for additional assistance with file addresses, cnnb=,:t <br />tfie EHD. ilgplications Irexeleed after 3:00 pim Will be processed the next business daly. <br />:r. The EHD'Arils rietify Elie rep-pli�cant 1f any EHD files e)ist. An appointment fnr review wriii Ixa cordirmil d <br />apprmximeCely test (10) day', afttx receipt of application. The files Will be held for a maximum of five businu: 4i <br />days for review. Applointntents Edtould be scheduled accordingly. <br />:5. A Me tbal is actively bating worked on by EMD staff may not be immediately available for review. A new <br />application xray be subn0e:d Mrflen the file is available. <br />,l- Any filo no' Teturned in the iame condition .as released veil] be reorganized by EHD staff at ttae expense of th a <br />appticl lL Fulture fife reviews by the same applicant may require a $95.00 deposit prior to review. <br />ONE sear <br />;VIM <br />q\' <br />