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Fm:Ecology andel Environment, Inc.-CSC To:San Joaquin Cty of Env Health Dept 14:2A 011 2 811 OGMT-08 Pg 01-01 <br /> R n �REGEtygp�D • EHD LOG NUMBER <br /> I(Ir,SU Ilr�u v � SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> JAN `L S 2010 600 East Main SI. Stockton, CA 95202-3W029 <br /> ENVIRONMENT HEALTHelephone: (209)468-3420 Fax: (209)464-0138 Web:WW.Sjgov.Drg/eh E/f1 <br /> PERMmSERVIGESS !PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Crd,91-acim , BUSINESSIAGENCY: fzdoqy br,,1 ✓60AUlnt <br /> ADDRESS: Iwo Ida {6t 51xk 100 CITY/STATEIZIP: Ookl vtcll C14 9y(a1a <br /> PHONE(1): 610.993.67oo exf•Yell PHONE(2): �// . 3oln.! FACSIMILE: 51o.55a.5?r&6 <br /> TENTATIVE'APPOINTMENT DATE: 9 2 In Time: //,qµq <br /> (Please allow 10 business days from date of application submittal-'Tentative only-must be confirmed) <br /> ❑CHECKBOX TO EXPEDITE REQUEST-$115 FEE(CASH OR CHECKONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATEJ ,]gl/O <br /> Electronic Information: ❑List❑Map-Description; <br /> FILE ADDRESS END USE ONLY <br /> Street# Street Name city (71 Unit <br /> ,. ISIS h7 OM1,614 5 eeiL s V) <br /> 2. 150 0✓ 0Unit2 <br /> 3• 11 I(D u5 f PP GK vl <br /> 4. <br /> nit 3 <br /> S. L�� <br /> 6. nit a <br /> 7. 04, <br /> 8• Unit 5 <br /> 9. <br /> 10. nil S <br /> Specl(Ic Date Range of Information Requested; From 'OVIUdfU t9'3' to TnrAM✓u 90)d <br /> �,/ ENVIRONMENTAL HEALTH EPARTMENT FILES �/ �^ <br /> L"J)1NDERGROUND TANK(UST)CLEANUPSITE(LOP) ❑HOUSING ABATEMENT rLErSOUDWASTE FACILDYNEHICLE <br /> Q0 THER CLEANUP SITE(Nom-LOP) El FOOD FACILITY tK*ASTE TIRE <br /> 1(�U DERGROUND TANK(MONITORINGIREMOvAI) ❑DOG KENNEL ❑DAIRY <br /> AZARDOUSWAsTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> IERED PERMirfEe FACILITY ❑MOTEUHOTEL ❑PUMPER TRUCKNARDICHEMICAL TOILETS <br /> ❑TATTOolBODY PIERCING ❑POOLISPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELLAND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY8:00AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List un 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 least one file type MUST be selected. Fax to(2091404-0138 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 EHD will notify the applicant If any EHD files exist. An appointment for review will be confirmed approximately len(10) <br /> days after receipt of application. The files will behold for a maximum of five business days for review. Appolnlments <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 applicallon maybe <br /> submitted when the file Is available, <br /> 4. Any filo not returned In the same condition as released will be reorganized by EHD staff at the exponse of The applicant. <br /> Future file reviews by the same applicant may require a$115 deposit prior to review. <br /> S. If you need further assistance,please contact Diane Martinez,at(209)468.3425. <br /> EHDUseoNLY <br /> EHD4e48 B2I109 <br />