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03/27/2006 22:59 12094721905 DEUTSCH PAGE 01 <br /> "' rccLkw�u SAN JOAQUIN COUNTY <br /> 2000 At'R -5 A' 10: 03 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> S A J 0 k%;­U i= v u N T'504 East Waber Avenuc, 3`d Floor,Stockton, GA 95202.2748 <br /> EPd d'Ifs pfd i`i E ld T n p�phoaTe:(209)468-3420 Fax; (209)464-0138 Web:www.sjgov,org/chd <br /> NE�1L i H DEPP,?T�_ <br /> PUBLIC RECORDS RELEASE APPLICATION z2a9 2 <br /> ,—�,e so_ VuslM!as A01=Y.' 1!2.4 <br /> ADDRfES5:._,.._.__(A_ 3 Q _CfTI' ,KT �- STATE <br /> PHONE;.(1)' PHONE(U FACSt"tLV_ - <br /> TEN7ATWAPP01lKTWKNTDAM- -- _ _ _tune:_ <br /> (pkm¢se silaw 10 truakTaee days fo m drato of 4pplia0on rubmkW-•TerT Oft 031y-Mad bo COn imU4) <br /> C7 CKWr HOK TO LWWfTfR t T-*M00 H OR f:WX ONLY)-KOUEST PROOF M IN 3 SUsNF-38 DAYS <br /> SIGNATURE OF APPLICANT <br /> L toLW G sv <br /> Map-DWRpt�^ <br /> tnfcxYeed94tt _..,.,,_....,�....r— <br /> FiE ADDRESS FHD USE ONLY <br /> reset a street Nam* <br /> ❑ Unit 1 <br /> 2. <br /> h - , -.., D Unit Z <br /> � ��;.� <br /> 4. .r+r ter' nit 3 I <br /> a. <br /> , unit 4 <br /> 7'. <br /> „rte U ..;'7 ❑ Un t 5 <br /> / Q Unit 6 <br /> Specific Dtfia Rpnvc of(r omatlan Requested:From to „^ Y-7ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ,eUr 0L4t(;W)1J%'�TAAK(U8')OmMUP ar v(LOP) G Fbu"G AeATx.Kw ❑Sorg WA91M F^Wr(IVZKr%E <br /> ,F>'OnWA CL&kN;P 3174"-LOP) o Food FAcKin t7 WAa1F TIRE <br /> ,zrL_*pwo*0L A TAJIX(M0Wy0Rp&?Zh10VA1) 0 DOG Kano--L DAIRY <br /> 'rir'tj^. acus WASTE QFWAAMS O CKMAN RAMCH fl WAtTt NAM TREATMWTP1AHT <br /> YlyREDPfR""0 FACUTY 0 MoTtLA1:7r-L ❑PuwwkTq=(fyAf:DA-, vMOALT)LITs <br /> TA-rood 00'p, Acwa n P/�,Q�O.�V$PA 0 LAM V"AreucA„ar Stays <br /> J MECICALWAtTt FArIJ' C30TKY t(%1AXSnCfY) — — <br /> Wc1.Ali?UrnC FEWT RLco%DE ARA AVALAa{.E FOR Rsvww -MONOAY•FKOAY 8:90 to.&-0W'A EEXCLt1MO k-;V;*ya. <br /> List up to ten addrost.”in.the apaCI AbOvt:. Select the type($)of files from the list above by chtcking the <br /> appropriate box(es). At 1aW ore filo type MUST be t/ ect6d. Otrw <br /> -eb we_ Addr"s rartpas will not bm accepted -for additional ars4stanC"9 with file nddreases,contact <br /> the EHD.A.pplicatk na recoNad attar 3.00 pm will be proceaaed the next bu$lnesr dZy. <br /> 2. The EHD will notlfy the apl=liurTt If any I;H0 fllso m6sL An Appointment fer review vrIN be aanfinned <br /> approximately ten(10)days after rveotpt of applioativn. The Elle$will be hold for a mgAm:urn of five businoss <br /> r <br /> ,as ror rcvtcw. Appointments should be scheduled amordingly. <br /> 3. A file that lel actively"ing worked on by F_HD staff may not be tmm#dlately &vailabirt for mviewr. A rev <br /> application may be submltUd when the file is nvalla►b(e. <br /> 4. Any fiie not returned in the same condition a% reloaeod will be morganized by EHD Ataff ad the txpenvcf the <br /> nppticfanL Future file reviews by the same appiicAnt may regUirs a1$93.00 daposit prior V)ravifswr. — <br /> tHQ M-01 <br /> �xaTR09F <br /> Ta Ir'"A 9b VZ' :61i 9R0z/S6/t0 <br />