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06/23/2005 14:03 916-371 09 RANEY GE(]TECHNIC PAGE 01/0 <br /> EHD LOG NUMBER <br /> DATE RECEIVED SAN JOAQUIN COUNTY <br /> ENVtJ oNm EN*L MAJGTH DL+'PA RTMFNT <br /> 3Q4 Fast Weber Avmue,3'd Floor, Stockton,CA.95202-2708 �oJON <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:WWWAigov.org/ehd ` , <br /> PUBLIC RECORDS RELEASE APPLICATION 14,AsAi t�'QtttfV�t3��r <br /> APPUCANT:n- !!!! h .- BUSINESSIAGENCY: <br /> ADDRESS: / J't <br /> PRONE(1)AW41371---a T 3 7 —PHONE(2): FACSIMi <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of appRcatial submittal-"rentaVn only-must be confh <br /> CHECK BOX TO EXPEDITE REQU[3ST- HeCK ONLY)-REQUEST PROCESSED iN 3 USINW DAYS <br /> J � <br /> SIGNATURE OF APPLICANT DATE <br /> UNIT DISTRIBUTION to Unit 1 nit Unit 8 nit 4 13 Unit 5 O Unit 6 17 Other(eladmlcAlstsimaps) <br /> _ FIi,E ADORE-0 EHD US ' D <br /> Stnaet# st r"t Name CRY _ <br /> _rt 1-1 _,C 7_� <br /> S. ST <br /> tom-e-.� iT�G1 4T'\'J 4. 9140_ We�tfo'u-r L4 br <br /> 5. <br /> -,J-Specific date Range of Informatkm Requested:From to - <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES 40 <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ®HousiN6 ASWEMEN t 13 SOLiD WASTE FAcLrrY1VrwK:LH <br /> OTHER CLEANUP SM(NON-t.OP) O FOOD FACRJTY E3 WASTE TIRE <br /> d UNDERGROUND TANK.r. E3(mowroRINOIRENOVAL) r3 D"KENNEL DAIRY <br /> X HAZARDON WASTI_VENERATOR CHICRE.N RANCH <br /> El TiERED PERM I FACiLiTY 17 MOTELMOM 0 PuMPtR TRUCK/YARo CHEM TON.ETS <br /> E7 TATT00IE300Y PIERCM C7 POWSPA 13 LAND USE APPLICATION SnEB <br /> E3 MEDICAL WASTE FAcLI Y E]OTHER(PLEASE SPECIFY) <br /> wELL AND SEP=PERMIT RECORDS ARE AVAILABLE FOR Review• MoNDAY•FRIDAY 6:00 AM-5:00PH ` EMUDING HOLIDAYS. <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 sdlected. Fax to[2091 464-013S or mail to the address <br /> indicated e_bove. Address ranges will not be accepted for additional assistance with file addresses,contact ru <br /> the EHD.Applications received after 3:00 pm will be processed the next business day. <br /> 2. The 1=HD wRI notify the applicant if any F.HD files exist. An appointment for review will be confirmed <br /> approximately ton(10)days after receipt of application. The files will be held fdr a maximum of five business <br /> days for review. Appointments should be scheduled accordingly. <br /> 3. A file 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 file Is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by 1-111)staff at the expense of the <br /> applicant Future file reviews by the same applicant may require a$9,3.00 deposit prior to review. <br /> -111)49-02-006 t. <br /> RUSH,naps <br />