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LODI DOWNSTAIR`= — PAGE 02/02 <br /> 05/20/2010 11:37 20933, <br /> EHD LOG NUMBER <br /> DATE RECEIVED SAN JOAQUIN COUNTY <br /> lJ UFC[E V [o ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 ovjor9/MAS' Z 1 I.UjO Telephone: (209)468-3420 Fax: (209)464-0138 Web: WWW.sjg <br /> ENVIROWENT HEALTH PUBLIC RECORDS RELEASE APPLICATION <br /> PE e BU$INESSIAGENCY: <br /> APPLICANT: !'A OS74f� <br /> 902 1n-d—U5 °IaI Wa) _ ekyrsea`erz'P 0�SP1 <br /> ADDRESS: FACSIMILE: 70-a(i9-4278 <br /> PHONE(1): 7f1Q- fiZ37W _ . PHONE(2): gam <br /> TENTATIVE*l APPOINTMENT DATE: 6-.3-1 <br /> Time:�.--- <br /> (Please all"10 business days from date of applicaGen submkDll-'Tentative only-must be confirmed) <br /> C3 CHECK Box TO EXPEDITE REQUEST-$105 FEE(CASH OR CHECK ONLY)•REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> DATE 5-21-10 <br /> SIGNATURE OF APPLICANT <br /> Electronic Information: [I List❑ Map-Description: <br /> EHD USE ONLY <br /> FILE ADDRESS _ _•, <br /> street x Street Name City E] Unit 1 <br /> 1. 603 San Juan Ave. L c Stockton L] Unit z <br /> 2. 621 San-jU.an-AVe._--. Stockton <br /> _ <br /> _3• 618 .. Ca.rltoLtAveStockton.... ..._ unit 3 <br /> 4. 620 San Juan Ave. Stockton U L)7) 5, �� <br /> nil 4 <br /> 5. �• - <br /> B. — <br /> ❑ unit 5 <br /> 7. <br /> 8. <br /> -- ❑ units <br /> 10. <br /> Specific bate Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES Y <br /> �( O HOUSING ABATEMENT ❑SOLID WASTE FACILITYIVEKICLE <br /> R�UNOERGROUND TANK(UST)CLEANUP SITE(LOP) FDDp FACILITY ❑WASTE TIRE <br /> )vv 1 OTHER CLEANUP$ITE(NON-LOP) 0 DAIRY <br /> IK <br /> UNDERGROUNU TANK � O❑DOGCHIDOG KENNEL KEN RANCH t3 WASTEWATER TREATMENT PLANT I <br /> HAZARDOUS WASTE GENERATOfdI ❑MOTEUHOTEL f7 PUMPER TRUCKIYARDICHEM TOILETS <br /> E3 TIERED PERMITTED FACILITY Q POOLISPA 13LAND USE APPLICATION SITES <br /> ❑TATTOOIBODY PIERCING 173OTKER(PLEASE SPECIFY) <br /> O MEDICAL WASTE FACILITY <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 8:00 AM-S:ODPM - EXCLUDING HOLIDAYS. <br /> the <br /> priate <br /> 1. List up to ten addresses In the space above. Select the types)of files from the list above 54-0136 or mail t ,the address nd crated aboveroAddess <br /> box(es). At least one file typo MUST be selected. F <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD. Applications recelved 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 /> taN may not be immediately available for review. Anew application may he <br /> 3. A file that Is actively being worked on by EHD s <br /> submitted when the file Is available. <br /> 4. Any file not returned in the same condition as ase a$105 deposit reorganized <br /> led byrevlew EHstaff at the expense of the applicant. <br /> m <br /> Future file reviews by the sae app mayrequire <br /> EHD USE ONLY 60 <br /> _ Z <br /> PUBLIC RECORDS RELEASE APP FORM <br /> EHO 48-06 8/04108 <br />