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TB 39Vd TV8Z86LOTET 8E:90 800Z/LT/LO <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />j1,1 1 7 2H8 600 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.orgle <br />PUBLIC RECORDS RELEASE APPLICATION <br />77r\IIP' SAN JOAQUIN COUNTY <br />FNViRONMEN{ HEALTH <br />C' <br />Ciltµa Cffelt OTPiaCk <br />PHONE (2): 75 FACSIMILE: <br />TENTATIVE* APPOINTMENT DATE: ZZ) Xi (Please allow tan bu m da oinott days from f applicat • submittal - *Tentative only must be - c;um) <br />qvn fi <br />m <br />APPLICANT: <br />ADDRESS: <br />PHONE (1): <br />CHEcK BOX TO EXPEDITE REQUEST $98. ) (CASH OR CHECK ONLY) - REQUEST PROCESSED IN THREE BUSINESS DAYS SIGNATURE OF APPLICANT <br />FE7=177707.maflon: 711st Ma - D scription: <br /> DATE <br />FILE ADDRESS <br />Street Name <br /> <br /> <br /> <br /> <br /> <br /> <br />B. <br />10. <br />Specific Date Range of information Requested: From it 1 to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />In HOUSING AATEMENT SOLiu WASTE FAcILITYVVEHICLE <br />UNDERGROUND TANK (frIoNiToRING/REmoVAL) C DOG KENNEL <br />DAAIRSYTE TIRE <br />AZARDOUS WASTE GENERATOR CHIcKEN RANCH XVVASTEWATER TREATMENT PLANT CI TIERED PERMITTED FAcioTy 0 MOTEL/HOTEL n PUMPER TRucKTYARD/CHEm TOILETS ?LTA rroO/Sooy PIERCING <br />MEDICAL WASTE FACILITY 11-LAND USE APPLIOA'naN SITES POOL/SPA <br />tl OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MoNDAy-FRiDAy 8:00 Am-,5:00Rtn - EXCLUDING HOLIDAYS. 1 List up to ten addresses in the space above. Select the type(s) of files from the list above by checking the appropriate box(es). At least one file type MUST be selected, fiLo rnAll to tb above address. Address ranges will not be accepted - for additional assistance with file addresses, contact the EH). Applications received after 3:00 pm will be processed the next business day. <br />The END will notify the applicant if any El-ID files exist. An appointment for review will be confirmed approximately ten <br />days after receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. <br />A file that is actively being worked on by the EI-10 staff may not be immediately available for review. A new application <br />may be submitted when the file Is available. <br />Any file not returned in the same condition as released will be reorganized by END staff at the expense of the applicant. Future file reviews by the same applicant may require a $98,00 deposit prior to review. <br />EVID USE ONLY <br />1 ity <br />e-ocicq-c(\ <br />tU <br />NCERGRoUND TANK (UST) CLEANUP SITE (LOP) <br />OTHER CLEANUP SITE (NON-LOP) C FOOD FACILITY <br />EHD LOG NUMBER <br />Street # <br />"S762, <br />EHD USE ONLY <br />tJ Unit I <br />/lifell---Unit 2 <br />/01.1.1 t 3 <br />71 Unit