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SAN JOAQUI <br /> ][ ff � <br /> L I14NMENTA.L HEALTH b t,p <br /> 304 East ;VeberAvenue, 3`d Floor, Stockton,CA 95202-2708 <br /> Te[efihotxe: (209)468-3420 Fax: (209)464-0)38 Web: www.sjgov.org/ehd <br /> . s <br /> PYJ73LIC RECORDS RELEASE APPLZCATIO*N ` <br /> APPUtANT: <br /> r44DV-Fss: 31110 ►,J_ BUS(NESSIAGENCY: llama F w SS f G <br /> PI�oNE(2y: r.�tl tv 4Sz 7�7f r� ------ <br /> f` <br /> TENTATIVE,A!'POINTI4tF_I'( GATE: FACSIMILE: t[G L 2 -7x 27 <br /> �. <br /> (Pic Ase allow 90 bus no=ea fr �� TFme: �a,^V%1 <br /> w r <br /> Y5 om ate of apPftcation telbmiffal-•r¢ll fi 6ye only-must be cont )cif <br /> • 3• F f tt OR CHECK ONLY)—REQUEST PROCESSED•IN a <br /> OF BusINES <br /> APPLICANT S I7IlYS <br /> t_}rSMF3LiTION Q Unit i t3 U <br /> nit Z I;3 Unit 3 © Unit�t Ugtt t= D Untt 6 d <br /> Mer(etectrohlcllistsht;ap�? <br /> - -- - t~ILE ADDRESS 5tiea K Street uasate <br /> city I~HD USE ONLY <br /> 10 �. <br /> fie Date Range of' <br /> fnformation I equestetl:From <br /> to <br /> ENVIRONMENTAL HEALTH DEPAkTMENT PILES - <br /> L)J406RGROWD TANK(UST)'CLM P�rrr_(L,OPy -0T"Er<CLE UW SrTE(Nor1-LOP) CyNosyc/ 3aTsaaNT <br /> t-SOM WASTE FACXM/VEM0LC- <br /> tINDEP.(3Rour1P TAW(M06VT0tU,4C„4:ZEjM'QVAL FoFActLITY [7 WASTE TtRe <br /> `! }1AZAF00O S W,�srF OCUE TOR } d od t?o KEWEL <br /> d Ct�J1 puwf i1 DAIRY <br /> rATr(.X CERLt77'EC FACtIJ7y WASTuWATEg TgeAtmEw PLAIrr <br /> 1 ATT<x'JBOoy PtERgNo d M TEIJf lom I-1 PvmPER TRUcKfyA.kkUcHELt TOILFTS <br /> Q �1f1H--AL YVAS TE FACB-rTy �r ooL)-.pA C]LA140 USrr <br /> n CITT! R(PLEAse SPEC M T+OI i Sties <br /> 4YE11 AND 5EF'TTC PEFu4r=ftEcoRas JUZE 1lYAll REL£FOR ReMWM,_4 DAY-FittDAY. Bid <br /> Go AK :0opu - I=7CCLUDIW,fiaa�ars.. <br /> _ ---�— <br /> t un to ton adds)^ses In ffte space above. Select the-We(c) of files from the list above by checking the <br /> ,.r�priafc boxes}- At feast one Site type MUST he selected_ ax to 209 484-0138 or mail to the address <br /> :i,� ,ted above. Address ranges will not bo Accepted—for additional assistance with fife addresses, cogtaa.;.: <br /> _•- EHD. ApPlications received affer 3:00 pt'n will be processed the nexf business day-' <br /> notify the applicant if any EHD riles exist An appointment for review will be confirmed <br /> `'x:matoiY ton (i0) days after receipt of apptication- The fifes Will be held for a maximum of five basin ;;: <br /> lar review. Appointnt tints should be scheduled accordingly. <br /> (T V <br /> si'c chat Is u.cfively being worked on by EHD staff may not be Immediately available for review. A ne-& <br /> ;-f'Iicativn may be submitted when the file is available. <br /> zy <br /> file not returned In the,same condition as released will be reorganized by EHD staff at the expense of tl11, <br /> kof l iGant T'Lrfure fele reviews by lite same applicant may require a$93.00 deposlt.prior to review. <br /> �_- <br />