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Jan 15 U t 1 U:11 a Apex 2C^667-9668 P.1 <br /> SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ,IAN 2. 9 2007 ENVIRONMENTAL HEALTH DEPARTMENT <br /> ENARONMENT HEALTH304 East Weber Avenue,3'd Floor,Stockton,CA 95202-2708 07 ;Z7Z <br /> PERMIT/SERVICES Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgoy.orw/ehd <br /> RECORDS RELEASE APPLICATION <br /> APPUCANT: D re-w Vcxvv AlLw. 13usiltEss/ACEIVCY: AyD-e3F <br /> ADDRESS: 3` 4l - M Crd(c.t.A.A ${cam L(L/r�, Sv► e G <br /> rurC4c1c cQ 75,78'L <br /> PHONE(I)- Z-ter - 1c497-1 PHONE(2): 4 — -L-6sz- ACSI NLE: Z=I (-67— 'i`co <br /> TENTATIVE*APPOINTMENT DATE: )-4- 07- Time: �g! 00 <br /> (Please asow 10 t>cainess days from data of oppf eaWn subm(tfal. Tentative <br /> asOnly-must iw conftraled) <br /> Q CHECK BOX TO EXPEDITE RE tiEg7'.1g�dl,ep FEE CASH OR CHECK ONLY}-REQUEST PROCESSED IN 3 3! E59 DAYS <br /> SIGNATURE OF APPLICANT ��-V� DATE ► Z@ O�- <br /> UNIT DISTRMu-nON 0 Unit 1 13 Unit 2 ❑Unit 3• ❑Unit 4 O UMt 3 ❑ Unit 6 ❑ OUW <br /> (ebclrorarAi �) <br /> FILE ADDRESS <br /> stnettt street Name ci END USE ONLY <br /> q K s <br /> 2. Z Ss '? <br /> 3. I <br /> 4. Zs7. <br /> Ju 9 G a <br /> w.` <br /> 9. <br /> • 1Q. <br /> SpecHic Date Range of WOrmation Requested:From "•^vt-i- <br /> ENVIRONMENTAL.HEALTH DEPARTMENT FILES <br /> XG IMpERL`sRDk�p Tact W"q CLEANUP SrrE(LAP) G G HOUNr a ABATEUM Soup WAM FACIUrdVEWLE <br /> OTHM CLEANUP Sire(Nora.Lop) a <br /> O UIroEMIUMNo TAW(MaamnrLLNCIIREMov 0 Poop.FApLLTY D WASTE MIM <br /> Dog KENNIl. <br /> t]HAMMOO(As WACM OMMATOR O DAMP <br /> O oTmj RANCH O WASTEWATM TF EATUMir PUNT <br /> O TATTmaoDy pw;cIN3m 13 AtPOOLISPA � ❑PWPXFt TMWWYARMVt=ToL rM <br /> E3 UMMAL WASTE FACILITY ❑0"M(PLUM C3 LAND USE APPUCATION&M <br /> _ SP6CP1f) <br /> VAML AND 8emc PER►sT RecaROB ARE AYA0.ABLE Port Rtvl11W- MONDAY-FRIDAY 8:00 A -5.00Pid - F-70CLUpfr((s HOLDAyg, <br /> 9. 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 209 1 r IT]a to th dd <br /> rew <br /> Lod101e4 above Address ranges will not be accepted—for additional assistance with Me addresses,contact <br /> the END.Applications received after 3:00 pm will be processed the next business day. <br /> Z The END will notify the applicant if any END files exist. An appointment for review will be confirmed <br /> aPproximatety ten(10)days after receipt of application. The files will be held for a maximum of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> $. A file that Is actively being worked on by END staff may not be Immediately available for review. A new <br /> application may be submitted when the file Is available. <br /> 4. Any fila not returned In the same condition as released will be reorganized by EHD staff at the expense of the <br /> applicant Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> _� 'l.-•� ;moi �i <br /> EH04"2*1 <br /> 1 ROS <br />