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DA1ERECEIVIED SAN EHD LOG NUMBER <br /> RRC ENED Eaux ONMNTAALHEAALTH COUNTY <br /> pho Fast Weber Avenue, 3"1 Floor, Stockton,b: ww.Sjg v.vr hd <br /> 708 <br /> MA'f $ T Z�iephoae: (209)468-3420)rax: (209)464-0138 Web:wmv.s,}gov.orgk 3 <br /> WARGNMENT HEA LIC RECORDS RELEASE APPLICATION _ <br /> APPL1CgNR; 11 a I eney/ palm Welch BU9INESSlA6ENC1': lVel!D naerson &Assocrath7c. <br /> ADDRESS: 90 Ind fitrlal Wav Lodi. CA 95240 <br /> PHONE(1)!_WP 676'73WJ. PHONE(2): FFIC31tA1LE: 209-369.42213 <br /> TE! <br /> IdTATPM*APPOINTMENT DATE: June 14, 2,006 TTme: 9M am <br /> (Please allow 16 business days Srom date of appOr4on aubmittal-*ten a m ony-mu34 be wnfimled) <br /> 13 cHGCt4 sox To ExPEDrM REQUEST-$93.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 aUSINCS3 DAYS <br /> SIGNATURE OF APPLICANT DATE May 31, 2000 _ <br /> UNITDISTRIBUTION GUna 1 MUM2 01.103 MUOK4 OUnK5 O Unite ❑ O@orjoketronWl naps) <br /> FILE ADDRESS EHD q�^ <br /> Sliest C sheat No" city 07 <br /> 1, 9015 Walnut Grave Thommn <br /> 3. <br /> 4. \� <br /> 6. <br /> 7. <br /> I IL <br /> Specific Date Rainge of Infonnaffion Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> M UNDERGROUNDTAHK(UST)CLEANUP SITE(LOP) O HousmG AmtwN 11 SOLID WASTE,FACMITYIY2HICLE <br /> E1 OTHER CLEANUP SITE(NowLOP) 17 FOOD FACILITY a WAM-TIRE <br /> EI UNDERGROUND TANK(MONITORINGfREMOVAL) RDOG KENNEL ❑DAIRY <br /> EI HATARDOUS WASTE GENERATOR 0CHICKEN RANCH ❑wAsruwATER TREATMENT PLANT <br /> 0 TIERED'PERMnTED FACILITY O MOTELMOML Q PUMFSIRTRUCKIYARDICHEIA TOILETS <br /> Cl TATToo/BODY PIGRcum D PCOUSPA ❑LAND USE APPLICATION SITES <br /> CI MEDICAL WASTE FACILITY In OTHER(PLEASE SPECIPTL Sgq Ines,MOW roma <br /> WELL AND SEFnC PERMIT RECORDS ARE AVAILABLE FOR RENEW- MONDAY FRIDAY SAO AM-9:00m - FXCLUMNG HOLIDAYS. _ <br /> 1. List up to ten addresses In the space above. Select the type(s)of flies from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax to(209144 138 or mail to the address <br /> In )cated atbve. Address ranges will not be accepted—for additional assistance with file addresses,contact <br /> the END.Applications received after 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant If any EMP files exist An appointment for review will be confirmed <br /> approximately ten (10)days after receipt of application. The tiles will be held for 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 END staff may not be Immediately avalrable for review, A new <br /> appl)oatlon 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 expense of the <br /> applicant. Future file reviews by the same applicant may require a;93,00 deposft pTlor to review, <br /> 6T'104Hff-0En <br /> iNYa3 <br />