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PAGE ei <br /> DAt UEi ��tl�fl,I� <br /> SAN TaAQUM COUNTY <br /> EH]LOG NUi�18t=R <br /> J �4 <br /> En wRoNANtENTA„L HEALTH DEPARTMENT 00000 <br /> CFP – i L„Uo 304 East Weber Avenue, 3'd Floor, Stockton,CA 95202-2708 I:> 0 <br /> Tele (tone: (209)458-3420 Fax:(209)464-0138 Web:wmnv-$jgov.org/ehd 20-.0151 <br /> `//,,////ENVIR f��l °�fITFIEALIF <br /> PERF" ':..; 'ICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Vg�J'c_: D� Q SU3INFSSIAGENCY:, 1;� CA�7v L' ��CS <br /> ADDRe s: 2�sdd� <br /> Abu) SQrW. zm 104win CA <br /> PHONE[§): 1 � !14( ( PH SINOLE: LS Z8S-k 1' i <br /> TENTATIVE*APPOINTN3ENT oATE: -Tines: <br /> (Please allow 10 dosimss days front date of appiIII submittal-*Tenfaove only.must be oordnnled) <br /> 0 CHECK BOX TO EXPEDITE REQUEST-$96.00 FEE(CASHCHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIC NATURE OF APPLICANT <br /> � �l� �DATE <br /> UNrr OWTmEuTION G Unit 1 ❑ Unit 2 O Unit 3 R Unit ❑UnfS S O Unft S C C1her[electrGni0li's5tslrnaps) <br /> StreetP FlLE SeretdNameESSEHD USE ONLY <br /> city <br /> a V4 Yjk I9 <br /> 10. � �— <br /> Specific Date Pange of Information RequLG4ed:From to <br /> yy,pp ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 'F+'+Uwzr,MvNu TANI:(UST)CLEANUP SIM(LORI<, ❑HOUSING ASATEMPNT SOLID WASTE FACIurrNEH LE1 <br /> QYRSR CLEANUP SITE(NoN-LOP)-/, CIFOoo FACILITY 11 WASTE TiRe <br /> UNDERGROUND TANK(SlIDNITORINOM M.OI ❑DOG KENNEL G DAIRY <br /> �1ALARDOUSw.4STEG*NEP��I1TOR.)C 13CIICIGEN RANCH wASTSWATHR TREATMENT PLANT <br /> -nERED PERMITTED FACIUTYx ❑PAOTE"TELPUMPER TRUGWYARPIC.HEM To'.LETS){, <br /> 'y0TA.TTOOIBOIYY PIE,"NG O POOLISP0. ❑LAND USE APPLICATION SITES <br /> �' <br /> •<'MR01CAL WASTE FACILITY X 0 OTHER(PLEASE SPECIFY) _ <br /> WELLAND SEPTIC PERMIT fiIECORDS ARE AVAILASLEFOR REVIEW- NiONDAY-FRIDAYS:00 AM5:00PM - EXCLUDING HOLIDAYS <br /> 1. 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 one file type MUST be selected. Fax to 120914.64.11323 er mail to the address <br /> Indicated above Address ranges will not be accepte6–IRUDddltional assistance wWh file addresses,contact <br /> the EHO.Applications received after 3:00 pm will be processed the next business day. <br /> 2. Th®EHD will notify the applicant If any EHD files exist An appointment for review will be confirmed <br /> approximately ten(10)days after receipt of application. The flies will iter held for a maximum of five busineEs <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file that is actively being worked on by END staff may not be Immediately available for revlew°. A new <br /> application may be submitted when the file Is available. <br /> R. Any file not returned in the same condition as.released will be reorganized by EHD staff at tier expense of the <br /> applicant Future fife reviews by the same applicant may require a$96.00 deposit prior to review. <br /> �7 <br /> EHO rias <br /> N9le' <br />