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� -20.06 9:52FM Adv--ced GeoEr,vi.ronmentaI F No, 4936 P. 2 <br /> CEIYED 10 EHD LOG NUf UZR <br /> j1SAN JOAQUIN COUNTY <br /> �� U <br /> EF�U ENVIRONMENTAL HEALTH EPARTMENT I� ' <br /> MAY 304 East Weber Avenue,P Floor, Stockton,CA 95202-2708 <br /> Telephone: (209)46873420 Fax: (209)464-0138 Web:www.sjgov.org/ohd ! <br /> EN�V(RONM' f HEALTH PUBLIC RECORDS RELEASE APPLICATION Z3,� 7 Iq <br /> APPLICANT: 'iuzanbf. dA BUSINESSIAGENCY: V h M int] <br /> ADDRI=38; S a a c J 5 <br /> PHONE(1): aU - 07-16)& PHONE(Z): g 0-_l hr a f FACSIMILE: <br /> TENTATPiE'APPOINTMENT DATE: 14?!lme AO& Time: :00 <br /> (Please allow 10 business days from date of Appikation submittal-•TentWye only-must be conffrmed) <br /> CHECK BOX TO EXPEDITEE T-$03.00 FEE(C GH K ONLY)-REQUEST PROCE,SED IN 3 BUSIh{ S DAYS <br /> SIGNATURE OF APi'L1GAl+1T - DATE -� <br /> UNrr DISTRIBUTION 13 Unit 1 &LI02 O Unft 3 13 Unit 4 C]Unit S 0 Unit B A Other(electronicllismimaps) i <br /> FILE ADDRESS EHD_USE_ONLY <br /> Street IR Street Name City <br /> 1. a , , <br /> 2. 8SJ- w wfW Ii <br /> i1 3. 1 d t� 1 it <br /> AA <br /> C" 9 �, u GAl, '` k <br /> u c( <br /> 5) <br /> 10. <br /> Specific Data Range of.information Requested:From to 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> tUUNDERGRouNo TANK(UST)CLEANUP SITE(LOP) t7 HOUSING A$ATEMENT ❑SOLIp WA6TE FACIUTYNE <br /> c3os TNER CuANuP BITE(NOWLOP) FoFAar-ETY C]WA$TeS,TI}�DERaitOVr�7D TA?{K(MgNrrOMNGI�MQVAL) ❑DOO KERNEL ❑DAIRY <br /> DOUS WASTE GENERATOR M[.HICK EH RANCH M WASTEWATER TFtFATMENT PLANT <br /> 0 TIERED PERMITTEQ FACIU Y 13 MOTELIHOTEL C3 Pu:SPER TRUcKffAR4(CHEM TOILETS <br /> *TATTWBObY PICfiC4NO d POOLISPALAND USE APFtIcAnoN SITES <br /> {]MEDICAL WASTE t'ACILCrY ❑OTHER(PLEASE SPECIFY} <br /> WeLL ANb.Qii: nc ftmirr RECORDS ARE AVAILABLE FOR REVIEW- MOMAY-FRIDAY$:00 AM-5:OOPM - EXCLUDING HOLIDAYS. <br /> 1. List up to ten addresses In the space above. Select the type(s)of files from the list above by ch�cicing the <br /> appropriate box(es). At least one file typo MUST be selected. Fax to(20914134-0138 or mail to the addms!� � <br /> Indicated above. Address ranges will not be accepted-for additional assistance with file addresses,contact <br /> the END.Applications mcelved after 3:00 pm will be processed the next business clay. <br /> 2. The EHO will notify the applicant If any EHD fifes exist. An appointment for review will be confirmed <br /> approkimataly ten(10)days after receipt of application. The files will be held for a maximum of five businw's M <br /> days for review. Appointments should be scheduled accordingly. ;1 <br /> 1 <br /> 3. A file that is actively being worked on by IEHD staff may not be immediately available for review.' A new <br /> application may be submitted when the file is available. <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the Expanse of the <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> s <br /> END 43424M <br /> (!14M <br /> i <br />