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_—LUL22/2005 15:43 2097959553 APERIO INC PAGE 02/0 <br /> 03/22/2005 15:38 464LENVIRONMENTAL . .STH PAGE 01 <br /> un1c LCI 00 7�7 ■T!1 A(�TTT1►i TT7►T�1�T <br /> SAAB Y1.AQVI COUNTY <br /> I <br /> T1 NNIRONMNTAL HEALTH DEFARTMEN)(' <br /> 304 Ex>t Weber Avenue, 3rd Floor, Stockton,CA 95202-2708 <br /> Telepho>rac:,(209)469-3420 Fax:(209)464-0138 Web:www.6jgov.org/eh (P71 <br /> 1005 MAR 22 PM 3 <br /> PUBLIC RECORDS RELEASE APPLICATION CA tj <br /> APPLICANT: � f INT Y <br /> 61.13INESSIAGENCY: <br /> ADDRESS: Aco' C9- qrZ 2 N VEPAR THAN T <br /> PHANZ(1): T-P PHONE(2): FACSIMILE: I-,zn <br /> TENTATIVE*APPOINTMENT DATE Apt,\ 5:. 24305— Tkm: ID_DO a r,-, <br /> (Please allow 10 buetness days from date of apprica on subrrllttai-*TentaSve only-must bo confirmed) <br /> 13 CHECK 64X TO EXPEDITE REQU <br /> KST-$93.00 FEE(CASH OR CHFCK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT / DATE 3-2 <br /> UWr t71STR1BUT10N Ll Unit 1 0 Unit 2 UDit S m Units Unit 6 0 Other(0lN4tro IGnLstsfrnaPs) <br /> FILE ADDRESS END USE ONLY <br /> Street>f Stmet Name dry <br /> 3. 1 <br /> 4, 1z1( \` � <br /> s. <br /> G, <br /> 7 <br /> s, <br /> 9. <br /> 10. <br /> Specific Date Range of Information Requestod: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT PALES <br /> IC um3oRatzwwo TANu(1,1ST}CLUNup&TE(LOP) 0 HOUOING ABATEMENT X floup WASTE FACILIrY1VEt1MM <br /> JR OTHER CLEANUP SuE(NON-LOP) 0 FOOD FACIl.1TY J2 WASTE TIPZ <br /> �UNow4pwunD TANK(MoNRARINQIRwA0VAL) M Dal!KENNEL E`1 DAIRY <br /> Elf HA2ARDous WAm GENERATOR M CHICKEN RAWH ❑WASTEWATER TRPAT1IENT PUNT <br /> ❑TUMID PCRNITTAD FACILrTY ©MO-MLMoTeL 0 PUMPER TMKWYAR0CHEM Toi xr- <br /> IM TATrWA0DY"IkC Ma ID p0q,J3rA to LAND 1.195 APPLIOAMN SITES <br /> 0 MEoicAL WASTE FAGZLrrY D OTWR(PLEASE SPECIFY) <br /> M" ft"M PiMKIT ReaOR04 Aha AVAILAWR I'M WMEW• MomPAY-FRIDAY 4,QQ A":00PM FXCLl mr,HOLIDAYS_ <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by chocking the <br /> appmprista box(a9). At Iaast one filo typo MUST be selected. Fax to(209)464-0138 or trail to the address <br /> indicate above. Address ranges will not be accepted—for additional assistance with file addresses,contact <br /> the EH0.Applit ationo received after 3:00 pm will be processed the next businsem day. <br /> 2. The EHD will notify the.applinant if any EHD files exist An appointment for review will be confirmed <br /> approximately ten(10)days after rcceipt of application. "rho filoo will be hold for a maximum of f{ve busInOSS <br /> days for review. Appointments should be scheduled accordingly. <br /> 9. A file that il actively belog worked on by END staff May not be Immediately available for ravlaw. A nbw <br /> application may be submitted when the file is available. <br /> 4. Any file not returned in the some condition as ntlellsod will be reorganized by EHD staff at the expense of the <br /> applicant. Future file reviews by the game&pplinant may raquiro&,$23.00 depoeit prior to ravlow. <br /> END 48 92.OK <br /> 11124M4 <br />