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9/17/2008 16:07 9155642 F_ KRAAN PAGE 02/02 <br /> EHU LQG NUMBER <br /> SAN JOAQUIN COUNTY <br /> I'ENVIRON:VIENTAI, 'Ii.F,/,.,]., '.1-IDH PARTMENT <br /> 600 East Main Street, Stockton, CA 95702-2705 <br /> Telephone; (209)468-3420 rax: (209) 464-0 138 Web: SVww,sjgbv.org/ehd <br /> gov.org/ehd <br /> PUBLIC RECORDS RELESE APPLICATION <br /> BUSINESSIAGENCY; <br /> APPLICANT: "91LL VLCA__ <br /> PHONE(1): PHONE(2): F/6' 'FACSIMILE; <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application sybmittal-*Tentaflva only-must be confirmed) <br /> XCHECK SOX TO EXPEDITE REQUEST-$ E(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 2 SU NESSDAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: F] List F-1 Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street Namo City IJ Unit I <br /> 1,_ LA <br /> 2. �qyB <br /> F-1 Unit 2 <br /> 4. unit 3 <br /> IR'Unli 4 <br /> 7, <br /> El Unit 5 <br /> 9. <br /> 90'Unit 6 <br /> Specific Date Range of filformation Requested; From to P11111) n 1* Awft <br /> 5 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 3 UNDERGROUND TANK(UST)CLEANUP SITE(LOP) El HQIJSI N G ARATEM Ef IT OLID WASTE FACILITYIVEHICLE <br /> _Lcl Thrft CLEANUP SITE(NON-LOP) 0 FOOb FACILITY 4ts(A S TE TIRE <br /> APNOIERCROW)TANK(MONITO RrNGIRV M OVAL) 13 Dbr.KCNNQL 0 DAIRY <br /> AZARI)OUS WASTE GENERATOR 0 CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT <br /> )ir_T1FRX--0 PERMITTIED FACILITY 1:1 MOTELIHOTCL. 0 PUMPER TmucK1YArm1GHcm T016F.T3 <br /> 0 TATT001130DY PIERCING MF3C)QLJ$PA 0 ILANt)USE APPLICATION SITES <br /> 171 IVIRDICAL WASTs FACILITY M OT14ER(PlLrIASE SPECIFY) <br /> WRr 1,AND SEPTIC Ptzwllrr RECORDS ARE AVAILABLE FOR Rc viEw - MONDAY-FRIDAY8:00AM-5;00PM - ExCLUDiNGHOLIDAYU, <br /> I. List up to ten addresses in the space abOVO. Seloct the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fox to(70$)404-0135 or mail to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance with file a dresses,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 ba confirmed approximately ten (10) <br /> days after receipt of application. The files will be held for a maximum of flyd business days for review. Appointments <br /> should be scheduled accordihgly. <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 fiIe_not returned--l-n-the same_E6 ndfi ii 66-as 661-a iasied-w ill-be reo r-9 an-iz-4—d by E-14U stiff at tate-iiiipid-nfe 6f-(IT-L.applicant. <br /> Future file reviews by the same applicant may require a$98.00 deposit prior to review. <br /> EMD USr=ONLY <br /> If you should need further assistance please contact Diane Martinez @ (209)468-3425 directly. Thank Y*U'*" <br />