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173/ 23/ 2011 14: 23 <br />DATE RECMVEr) <br />A <br />5308722968 <br />Dn8 <br />SAN JOAQUIN COUNTY <br />EIR R <br />V..' ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main St. Stockton, CA 95202-3029 <br />MA /T�Iephone: (209) 468-3420 Fax: (209) 4640138 Web: www.sjgov,org/ehd <br />PUBLIC RECORDS RELEASE APPLICATION <br />Environmental, Inc. <br />ADDRESS: PO Box 1956 <br />NESS/AGENCY: <br />PAGE 01/01 <br />EHD LOG NUMBB <br />1 <br />CITY/STATE/ZIP: Paradise, CA 95967 <br />PHONE (1): 530/872-2958 PHONE(2): FACSIMILE: 530/872-2968 <br />TENrATWE`APPOINTMENT DATE: <br />Time- <br />(PlOasg allow 10 business days from date of application submittal - "Tentative only - m st be Conflrmed) <br />CHECK BOX TO EXPEDITE REQUEST . $115 FE (C SH OR CHECK ONL <br />SIGNATURE OF APPLICANT 4 Cr.✓h0 <br />Electronic Information <br />[] List ❑ Map — Description: <br />REQUEST PROCESSED IN 3 BUSINESS DAYS <br />DATE 3 -2 3 -- 21�1/, <br />Lj TATTOO/BODY PIERCING ❑ POOL/SPA `L IJ PUMPER TRUCK/YARD/CHEMICAL TOILETS <br />El MEDICAL WASTE FACILITY OTHER (PLEASE SPECIFY) 0 LAND USE APPLICATION SITES <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEw: MONDAY -FRIDAY 8;00 AM-5:00pM (EXCLUDING HOLIDAYS) <br />1. List up to ton addresses In the space above. Select the type(s) of files from the list above b checkingthe appropriate <br />box(es). At least one file type MUST be selected. Fax o 209 as -013$ or ail to the dress ind ted aboAddress <br />ranges will not be accepted -far additional assistance with file addresses, contact the EHD. Applications received after <br />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 approximately ten (10) <br />days after receipt of application. The files will be held for a maximum of five business days for review, Appointments <br />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 now application may be <br />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 applicant. <br />Future file reviews by the same applicant may require a V 1 deposit prior to review. <br />S. If you need further assistance, please contact Diane Martinez, at (209) 468-3425. <br />