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05/27/2005 13:18 949-586-,7315 AMES - LUIS PEREZ� PAGE 01 <br /> 7 EN•IVIRCIHMEFITAL HEALTH P4-V <br /> DAT u ILrr, E eE Q enu�v� iw l•n.. . <br /> SAN JOA UIN COUNTY <br /> ENVIRONMENTAL HEALTH Don, CA 9 DEPARTMENT .i.� <br /> 2 7 2005 '' '' f=ast Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 I !/ <br /> 1'rlep',• tee• (209) 4683420 Fax: (209)464-0138 Web: wwa-jgov.orp'ehd <br /> ENVIRONMENT HEALTH <br /> PERMIT/SERVICES P('8[-IC RECORDS RELEASE APPLICATION <br /> APPLICANT - _ _ - tyZE- BVSINESSIAGENCY: <br /> ADDRESS:. I LL`fZ. �_t O - el <br /> PHONE(7): 9Y9: L/9 �-}�_PH NE(2): ^•� yl-D FACSIMILE:, <br /> TENTATIVE"AI'FC:`,TMENTDAIL: `A — Time: -147q <br /> /P7. <br /> (Pie•+.• Int w if, •ur ineea days from date of applicaeon submittal-*Tentative only-must be cmfirmedl <br /> 171 CHECK BOX.TO E7rirFn Ts RFOUEST -$93. ASH OR UE3T PROCESSED W 3 BUSINESS DAYA <br /> SIGNATURE OF APPLICANT e DATE P-S'• <br /> l UNIT oiSTRieu-noN _...T..'^U•ilt ❑ Un tel ❑Unite d Unite O Otho(eleetronlGllstF/maP3) <br /> FILE ADDRESS END USE ONLY - <br /> StTeete %bW Name City <br /> 4 .5: . yosesn re _ - - -- osa- Dpn� <br /> S. <br /> 9. —_ - <br /> 10. 1 _ <br /> Specific Date Range of Infemlartn Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES 1/ <br /> 0NpERGRWND TANK(VST) 5 n(LOPI O MOUSING ABATEMENT b SOLID WASYt!FACILITY <br /> ���rrrr TNER CLEANVP SITE INOWLOP 11 FOOD FACILITY O WASTE TIAF <br /> ANDEROROVNo TANK(MONITORINC'S`;.MOYAL) 0 00 KENNEL 0DAIRY <br /> r-ELHgra <br /> ArAROOUS WASTEGF,NEPATnP 0CNICKEN RANCH OWAaTE`NAt[R TREATMeNT PLANT ./ <br /> O TIERED PERMITTED FAcm-+ ❑MOTELIMOTEL O PVMPSRTRVCK(YARDICMEMTOILETS <br /> O TATTOOIBODY PIERCING ❑POpLISPA ❑LANp Ube APPLICATION Sn FS <br /> d MEDICALWASTE FACILITY O OTHER(PLEASE SPECIFY).—.._._ _ ...--__..... <br /> WELL AND SEPtIC PEI 'I,CORDS ARE AVAIUSLE FORREViFW - MONDAY-F"AY 8:00 AM•S:Dopi, . [xdLUDIM6 MOUDAYS. - <br /> 1. List up to ten addresses In the space above. Select the types)of files from the list above by checking the <br /> appropriate box(es), At least one file type MUST be selected. Fax to(209)464-0130 or 1101461 10 the address <br /> indicated above. Address ranges will not be accepted-for additional assistance With file addresses,contact <br /> the EMD.Applications te.eived after 3-00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant if any END files exist. An appointment for review will be confirmed <br /> approximately ten I10) days atter receipt of application. The riles 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 beirig worked on by END staff may not be immediately available for review. A new <br /> application may be submitted when the file is available. <br /> 4. Any Tile not returned in the same condition as released will be reorganized by END staff at the expense of the, <br /> applicant. Future file nIY iews by the some appllcant may requlre a$93.00 deposit prior to review.w. _. <br />