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Mar 2.2 2005 4: 58PM IyesneH [Consulting (2�'") 668--2598 p. 1 <br /> i <br /> DATE RECEIVED t Hu Luu NUNILIth <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue,3rd Floor,Stockton, CA 45202-2708 d <br /> Z005OR 23 W*_"(209)(209)468-3420 Fax:(209)464-0138 Web:www.$)gov.orglehd <br /> S'AN jot,oum UBUMIC RECORDS RELEASE APPLICATION <br /> APPLICAi Pi r. BUSINESSIAGENC:Y: <br /> ADDRESS .d i <br /> PHONE(1):� � -'�� PHONE(2): � G Jc, _FACSIMILE. <br /> TENTATIVE"APPOINTMENT DATE: f Time: <br /> ii (Please allow 10 business days fromidate of apppeadon submittal-"Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQ -S93.f}! 5H OR CHECK ONLY)—REQUEST PROCI=.BSER iN 3 BUSINFSS DAYS <br /> i� <br /> SIGNATURE OF APPLICANT DATE <br /> UNIT DISTAiBUTIQN Cl URIC 1 ;At 2It 3 i¢ O Unit 6 Unit e O Other(etectrontclllstslmaps) <br /> I FILE ADDRESS <br /> street' Street Name I City EHD USE ONLY <br /> 1• L I 'L <br /> 2- 119!+IS _gAL- <br /> WAV ix- 1 <br /> 3• 1 ►'f1 IRW4 <br /> 4. k <br /> 5. <br /> 7• i ] s <br /> 9. i. <br /> k <br /> Specific Date Range of information Requested:From to <br /> II ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 9( NOERGROUNb TANK(UST)CLEANUP SITE(LOP) j E3 HOUSING AnATE6mENT I��y�OLID WASTE FACILITYIVEHICLE <br /> �t��THERCLEARUPSITE(NON-LOP) ``Ca FOODFAcILETY H WASTE TIRE <br /> HCERGItoumDTANK(IIMONI ORINGIREMOVAL) i C3 Doo KENNEL �DAIRY <br /> ���'// 5 WASTE GENERATOR F O CHCKEM RANCH 0 WASTEWATER TREATMENT PLANT <br /> TIERED PER=TEO FACHAY p 13,itMOTELIHOTEL ❑PUMFERTRUcrfYAROICHEMTOILETS <br /> ❑TATTOOIBODY PIERCING .10 POOLISPA LAND USE APPLICATION SITES <br /> M MB01M WASTE FACILITY 113 OTHER(PLEASE SPECIFY) <br /> �j WELLAmnSep=PERMrfR=RDSAREAVAILABLE FOR REYIEW- MONDAY-FFWAYB:00 AIM-6:e0PM - EXCL.UDiNeHOLIDAYS. <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 t2(20M)464-0138 or mail to the address <br /> Indicated above. Address ranges will not be accepted—foe additional assistance with file-addresses,contact <br /> the EHD.Applications received after 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant If any EHD files exist. An appointment for review will be conrumed <br /> approximately ten(10)days after receipt of application. The files will be held for a maximum of five business <br /> days for review. Appointments should be4 scheduled accordingly. <br /> t <br /> 3. A filei:that is actively being worked on by EHD staff may not be Immediately available for review. A new <br /> application may be submitted when the rile Is available. <br /> 4. Any fife 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 /> s <br /> EHd 1EA2-0OB ... , <br />