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02/17/2009 16:44 FAX 4159573001 DUANE MORRIS LLP-SF Z 002/002 <br /> DATE RECEIVED SAN JOAGIUIN COUNTY EHD LOG NUMBER <br /> �� <br /> (� �� <br /> ED ENVIRONMENTAL HEALTH DEPARTMENT <br /> COO East Main Street,Stockton, CA 95202-3029 <br /> FEB 1 v 2009 Telephone: (279)468-3420 Fax-, (209)464-0138 Web:www.sjgo . d <br /> ENVIRONMEITF HEALTh PUBLIC RECORDS RELEASE APPLICATION <br /> PERM{ I . . n <br /> APPLICANT: i�I h0Uj�_� yy� L� 0. n `G.s BUSINESS/A <br /> fGENCY: <br /> ADDRESS: ()'k Wkw—i �4'V1.T0,-AA 5,1f"+ 2-am Clty/Statelzip S1/1 'rr4O\C%jCc1 / <br /> PHONE(1): Yf S- O — PHON`I,1(2): �Z $7d- 3Gc5 FACSIMILE: 4l(S <br /> TENTATIVE.*APPOINTMENT DATE: V�` �-� / 2 Time: 10 `�V <br /> (Please allow 10 business days from date of appllratlon submittal-'Tentative only-must b0 Confirmed) <br /> ❑ CHECK BOX TO EXPEDITE RB,QUES FEIi FA R CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑List❑ Map-Description: <br /> FILE ADDRESS _ EHD USE ONLY <br /> Street# Street Name City ❑ Unit 1 <br /> 2. rtPPPPa+lce ap57 o(Z)WUnit 2 . <br /> V 3- (`656 /tet' _ ti (D.15 <br /> 4. T Unita <br /> 5. <br /> — - --- Unit 4 <br /> s. <br /> 7. <br /> ❑ Unit 5 <br /> 8. <br /> L19. ❑ Unit 6 <br /> 0. <br /> Specific Date Range of Information Requested:From 9 6 to zomw /o <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES I�� <br /> f1jN <br /> OCROKOuND TANK(UST)CLEANUP SIT[(LOP) ❑HOUSING ABATEMENT 13SOLID WASTE FACILITY/VEHICLE <br /> HER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY 0 WASTE TIRE DERGROUND TANK(MONITORING/REMOWAL� 13 DO©KENNEL DAIRY o/ d �J <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY 0�, Q MOTELIHOTEL ❑PUMPER TRucWYARD/CHEM TOILETS / l <br /> 11 TATToomonY PIERCING 0 POOLISPA In LAND USE APPLICATION SITES <br /> ❑MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT R=C RDS ARE AVAILABLE FOR REYIEYY- MONDAY-FRIDAY 8:00 AM-5:00PM -EXCLUDING HOLIDAYS. <br /> 1. List up to tan addresses in the space above. Select the type(s)of tiles from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(209)d64-0138 or mall 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 nest business day. <br /> 2. The EHD will notify the applicant f any EHD fllas axiat. An appointment for roview 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 new 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 END staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$105 deposit prior to review. <br /> EHD USE ONLY <br /> N e(z <br /> s 6 O1Dyl� l <br /> I <br /> EHD 48-06 8104/08 PUBLIC RECORDS RELEASE APP FORM <br />