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a <br />From: <br />08121 17 17:07 4729 P.001/001 <br />%a IWI 2094640138 ENVIRONMENTAL HEALTH PAGE 01/01 <br />L14MU L �SANEHD LOG NUMBER <br />.��At�T.TZN COUNTY <br />AUG 2 % 2007 ENVIRONMENTAL HEALTH DEPARTmF.NT <br />600 East Main Street, Stockton, CA 95202 <br />ENVIRONMENT HEA' Telephone: (209) 468-3420 Fax: (209) A6"138 Web: www.sjgov,o <br />PERMIT/SERVICES <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT: L �� `� .r, BUSINESSIAGENCY.SS�wG <br />ADDRESS: 5 10� c 7 14 ps' � <br />PHONE (I): _ Z0r7 �.�' i_�J�� (2): 2� % ��J - <br />TENTATIVE' APPOINTMENT DATE_ Time: LP fto <br />(Plaase allow 10 business dAA from date of application submittal - `TentabW only - must be conflrme <br />CHECK BOX TO EXPEDITE fiEQUES 590 FEE ( H O CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIG ATO E t3F APPLICANT DATE <br />Electronic Information: 0 List ❑ Map — Description: <br />A UNDERGROUND TANK (UST) CLEANUP SITE (LOP) 0 HOUSING ABATEMENT 9rDmRly <br />D WASTE FACLI I � <br />�1 j ER CLEANUP SITE (NON -LOP) 0 FOOD FAc1LnY TE TIRE <br />UNDERGROUNo TANK (MONITORINGIt(EMOVAL) 11 Doo KENNEL <br />HAZARDOUS WASTE GENERATOR © CHICKEN TEWATER TREATMENT PLANT <br />T)ERBo PERMITTED FAciuTY I7 MOTEL/H C7 PumPrR TRUGKIYARDICHEMTOIL6TS <br />TATT(10/EODY PIERCING 17 POOLISPA © LAND USE APPLICATION SrrEs <br />MIE?o(CAL WASTE FACILITY O OTHER (PL SE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AYAIO.AaLE FoR RFviFw - NOONDAY -FRIDAY 8:00 AM-5:00PM - EXCLUDING HOLIDAYS_ <br />1. List up to ten addresses in the space above. Select the types) of files from the list above by chacktnp the appropriate <br />box(es). At least one file type MUST be selected. Fax fo (2091444.0138 or mail to the address indicated above. Address <br />ranges will not be accepted — for 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 FHD will notify the applicant if any EHD >lles exist. An appointment for review will be confirmed approximately ten (10) <br />clays 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 END staff may not be immediately available for review. A new appilcation may be <br />submitted when the file is available. <br />Q. 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 game applicant may require a $95.00 deposit prior to review. <br />EHD USE ONLY <br />, 005- 0 <br />