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4 <br /> 08/27/2007 }08.78 FAX 0021002 <br /> 11/1G/21306 08:54 46481: I=NV1HUNl1MNIA� i -'Lin .� <br /> AN SOA(�iJZN EHD LOG N[JNS6l+R <br /> Q Cou 1 y <br /> EN_V kQNNTN'TAL REALTH DEPARTMENT <br /> 304 Last Weber Avenue, 3rd Floor, Stockton,CA 95202- <br /> 94,W- Telephorie:(209)468-3420 Fax:(209)464-0,138 Web: www.sj03 <br /> PUBLIC Rr,CORDs RELEASE APPLICA, 4N <br /> APPLICANT. =j^ -Ah /) ' BUSINES3l4Gt'_Nt;Y: 11�1e,�_}{ dem <br /> ADDRESS: 0 7 /1 t xs <br /> PHONE(1): pHOtve(,Z): a,?-9'y 9-Zl6- <br /> FACSirWTLEt <br /> TENTATIVE`APPOINTMeNT DATE: oma; <br /> (PkeiA O a[fow 10 business days from date of appliicagon Submittal•'T4aiadve only-must be confirmed) <br /> 4 CHECK aox ro EXPEDrrE REQUEST-$93.00!EE(CASH OR CHC!K ONLY)-REQUE T PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OFAPPLICANT DATE <br /> �w <br /> Electronic Information: CJ List d Map--Description, <br /> FILE ADDRESS EHD USE ONLY <br /> Street g street Flame CEtar U Unit 1 <br /> 2• 5� OrrrG v !^� ❑ Unit 2 <br /> 3. <br /> unit 3 <br /> 5. <br /> ntt 4 <br /> 7, ❑ unit <br /> Specific Date Range of Informahlan Requested:Frt:m to _ <br /> ENVIRONMENTAL'HEALTH DEPARTMENT FILES <br /> UNMP.SROUMD TANK(UST)C,LEmup 5rm(LOP) ) ❑HOUSING ASAT&*r'NT M SOM WASTe FAC UTY1VENKLE <br /> o EFZt CLkattUP SITE(Nor,-LOP) ❑FOOD FACKM 0 WASTE'nRE - <br /> rJD�acJtoLirJlr T= <br /> (MONIroklNravAL) o aoc!CE]JNF� DAIRY . <br /> RMUS WA-VT GENWtATan t2 CMKFhJ PANCH ❑WA.ST1ri4TER TReATraEN PLANT' <br /> Q TIEREDPenmITTOFAcnxiy ❑VdTELII•IOTEL O PumPERTRUcKC1YAPW0NEMT01LETS <br /> I3 TATT001BODY PIF,RONS 13 PODUSPA 171 LAND USE APPLICATION Srres <br /> 0 MEDICAL W"TE FAcmv to O'MCR(PLEAS[:W1011Y) <br /> 1. <br /> WEL.LAND$OPTIC PERMrr:FtEvotws AREAYAJLAsLH FOR REviEw - MoNoAY-FN12AY 8:00 An-5X0PM - EXCLUON01401JDAYS. <br /> 'S. L.Ist up to ten addresses In the space above, Select the type(S)Of files from the list above by checking the appropriata <br /> box(es). At least alta 1719 type MUST be selected. _Fax to(209)46"138 or innif to lb9 address IndicAftd above.. Address <br /> ranges wits not be accepted—for additional assistance with file addrassos,contact the EHD. Applications recetvad after <br /> 3:00 pm will be processed the next bUSinass day. I <br /> 2. The EHD will notify tha applicant If any EHD files exist. An appointment for review will be confirmed approximately ton(f 0) <br /> days after receipt of application. The files will be held for a maximum of five business days for review, AppaintmAnts <br /> should ba scheduled accordingly. <br /> 3. A file that Is actively being worked on by ERR staff may not bra immediately availabla for rovlew, A new application may be <br /> submitted when tiro Tile Is available. <br /> 4, Any file not returned in tho same condluon as released will be reorganized by EHD staff at the expense Qf the applicant. <br /> Future fife reviews by the same applicant may require a$95.00 deposit prior to reviow., <br /> l <br /> EHD USE ONLY <br />