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07/14/2008 14:35 CLAYTnN PLEASANTON 4 12094640138 NO.954 P001 <br /> L� =4 TJIN COUNTY <br /> A X 1 H0 L4G NUMBER <br /> 4 - SAN JOA`J Q <br /> I � ENVMONMENTAL HkALTH DEPARTNMNT <br /> 7 LJ'U 304 East Weber Avenue, 3rd Floor,Stockton,CA 95202-2708 <br /> E.�V"� f fiA �,-�c"'1 Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/e <br /> �I` -S PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:Al 11&.)Y\ Ot'CIl4� BUSINESS[AGENCY:4JureA4-UC 1r1 <br /> ADDRESS: O7 Z� It rl'�1�'1 lyIL y <br /> " D) abPHONE(1) s ^201) PHONE(2). <br /> TENTATIVEkAPPOiNTME-NTDATE- A K OT Time: <br /> (Ploaso allow 10 business days from date of application submittal *Tenta6ve only-must be confirmed) <br /> L7 CHI=CK BOX TO EXPEDITE RE-QUEST-$93.00 FEE(CASH OR CHECK ONLY)-REt1UEST PROCESSED IN 3 SUSINESS DAYS <br /> SIGNATUKE OF APPLICANT DATE `6 <br /> WT DISTRiBUTiON D unit 1 0 Unit 2 r Unit 3 D Unit 4 d Units 0 Units 0 tither{electronicMstslma ) <br /> FILE ADDRESS EHD USE <br /> Street Streat Name ry city <br /> 1. C4 P10 <br /> 2. IgTr I Ajo o, <br /> 3. rill I0 60(6 ni <br /> j 4. 1w, 11vVr'C4t_:1. <br /> V e <br /> 8. <br /> Specific bate Runge of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FfLES <br /> EUNr]F.RC;RDIJNO TANK(UST)CLEANUP SITE(LOP) ❑Hou5ma AsaTEmEN7 SOLID WASTE FAC! <br /> THER CLEANUP srrE(NDN-LDP) �ooD FACILITY wasTE TIRE <br /> UNDERGRDUND TANK(MONITORINGIREMOVAL)� DOG Kr NNE1_ DAIRY <br /> HAzARDous WASTE GENERATOR D( CHICKEN RANCH >OWAM-WATCR TREATM ENT PLANT <br /> d TIEIYCO PCaMn-rcu FACILITY ISIIQTENHOTEL PUMPER TRi1C1G/YARo1CHEA1 Tbl (� �. <br /> TATTOOMODY PIERCING;x IPCOLISPA ALAND US APPLICATION StM5 I- <br /> 6DICAL WASTE FACILIb OTHER(PLkAsE SPkctrY) <br /> TIC)( <br /> WELL AND SEPTIC PERr4rr RECORDS AR2 AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8.00 Ah";DOPM - ExCl.urma HouDAYS. 0&VMM <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the G/© <br /> Appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail_to the_adare! <br /> indicated above. Address ranges will not be accepted—for 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 confirmed <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 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 j <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 EHD staff at the expense of the <br /> applicanL Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> �- -p� '. r ifs 15 for Z o 7, u�m isI(S <br /> Jed--.7 <br /> END 44-VADO <br /> 1Haro8 <br />