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49/17/2008 16:{{07 <br />I� <br />_ ] 1 <br />APPLICANT: /6/ <br />9165642?22 <br />KRAZAN - <br />PAGE 02/02 <br />*woe SAN JOA,QUIN COUNTY N%MW EHU LUG NUMBER <br />ENVIRONi1 ENTAI1 fJ.FA.T,1')I'E-r 'DI,PARTMI,,NT <br />600 East MainStreet, Stockfvi, CA 952()2-2708 <br />Telepbo ic. (209) 4683420 Pax: (209) 404-0138 Web: www.sjgov.crg/chd <br />PUBLIC RECORDS RELEASE APPLICATION <br />L�BUSINES/SIiAGENCY: <br />ADDRESS +PHONE (1): PHONE (2}:2 � <br />W..FAC$IMILC: <br />TENTATIVE* APPOINTMENT DATE: Time: <br />(Please allow 10 <br />SIGNbusiness days from date of ipplicatlon submittal - "Tentaflve only - must be confirmed) <br />HECK BOX TO EXPEDITE REQUEST -$98 E (GASH OR CHECK ONLY) , REQUEST PROCESSED IN 3 SU NESS DAY$ <br />XC <br />AOF APPLICANT DATE G ' <br />Electronic Information: ❑ List ❑ Map - Description: <br />13 HOUSING ABATEMENT <br />FILE ADDRESS <br />—_— <br />EHD USE ONLY <br />IJ F000 FACILITY <br />- Street # <br />Street Name <br />CityLL - "~ <br />Unit 1 <br />A-ZARDOUS WASTE GENERATOR <br />n CHICKEN RANCH <br />WASTEWATER TREATMENT PLANT <br />r2. <br />❑ MOTELIHOT0, <br />Ll PUMPER T <UCKlYARDICHEM TOILETS <br />(� TATTQ01130DY PIERCING <br />Unit 2 <br />© LAND USE APPLICATION SITES <br />wo"Ll 3 <br />4 <br />Unit 4 <br />7. <br />El Unit 5 <br />B. <br />9. <br />10. <br />Spocific Date Lange of Information Requested: From <br />to N Amt. <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES U`j V, <br />UNDERGROUND TANK (UST) CLEANUP SITE (LOA) <br />13 HOUSING ABATEMENT <br />ROLID WASTE FACII.ITYNEHIC>,E <br />OTHER CLEANUP SITE (NON -LOP) <br />IJ F000 FACILITY <br />ASTE TIRE <br />UNDERGROUND TANK (MQNITQRiNGjREMOVAL) <br />13 06; KCNNEL <br />DAIRY <br />A-ZARDOUS WASTE GENERATOR <br />n CHICKEN RANCH <br />WASTEWATER TREATMENT PLANT <br />iERED PERMITTED FACILITY <br />❑ MOTELIHOT0, <br />Ll PUMPER T <UCKlYARDICHEM TOILETS <br />(� TATTQ01130DY PIERCING <br />❑ POOLISPA <br />© LAND USE APPLICATION SITES <br />MEDICAL WASTE FACILITY <br />13 OTHER (PLEASE SPECIFY) <br />WELL AND SrPTIC FERmrr RLCORDS ARE AVAILABLE FoR REVICW - MONDAY -FRIDAY 8:00 AM-5:OOPM - EXCLUDING HOLIDAYS. <br />1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checking the appropriate <br />box(es). At feast one file type MUST be selected. Fax to (209) 464-0135 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 />9:00 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 (to) <br />days after receipt of application, The files will he 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 ovallable for review. A new application may be <br />submitted when the file is available. <br />a, Any file not returned In the same condition as released will be reorganized by E110 staff at the expense of the applicant. <br />Future file reviews by the same applicant may require a $9$.00 deposit prior to review. <br />EHD USE ONLY <br />" If you should need further assistance please contact Diane Martinez @ (209)468-3425 directly. Thank YouXHO 4B.06 51102006 <br />— <br />