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MAP,/31/2008/BION 05; 00 P14 COS <br />PATE RECEIVED <br />& REDEV <br />FAX No, 2099375099 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 464-01.38 Web; www.sjgov.o /e i <br />PUBLIC RECORDS RELEASE .APPLICATION <br />P. 001/001 <br />EHD LOG NUMBER <br />TENTATIVE* APPOINTMENT DATE: B PAI I a! n69 Time: , -W <br />(Please allow 10 business days from date of application 4uBmittal -Tentative only - must be conflrr d) <br />CHECK BOX TO EXPEDITE E T - V7.00 PEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN s BUSINESS DAYS <br />SIGNATURE OF APPLICANT DATE 13.1 <br />Electro nic'l nformatio n: ❑ List ❑ Map — Description: <br />FILE ADDRESS <br />EHD USE ONLY <br />❑ Unit 1 <br />Street # <br />Street Name City <br />2. <br />❑ Unit 2 <br />3. <br />Unit 3 <br />- <br />A <br />— <br />Unit 4 <br />7. <br />❑ Unit 5 <br />8.... <br />_ ...... .. _... <br />. <br />g. <br />❑ Unit B <br />' .ne.ciflc bate Range of Information Requested: From (� i D J tq� (a— to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />{ _DERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT 13 SOLID WASTE FACILITYNEHICLE <br />THEIR CLEANUP SITE (NON -LOP) 0 FOOD FACILITY ❑ WASTE TIRE <br />UNDERGROUND TANK (MONITDRINGIREMOVAL) 11 Doe KENNEL DAIRY <br />t HAZARDOUS WASTE GENERATOR C3 CHICKEN RANCH d WASTEWATER TREATMENT PLANT <br />6_ TIERED PERMITTED FACILITY d MOTELIHOTEL O PUMPERTRUCK/YARDICHEM TOILETS <br />t M TATTOO/BODY PIERCING M POOLISPA n LAND USE APPLICATION SITES <br />y; MEDICAL WASTE FACILITY ❑ OTHER (PLEASE SPECIFY) _ <br />fi <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONpAY-FRIDAY B:OO AM-ti;OOPM -EXCLUDING HOLIDAYS. <br />List up to ten addresses in the space above. Select the type(s) of files from the list above by checking the appropriate <br />b'ox(es). At least one file type MUST be selected. Fax to (209) 464-0138 or mail to the address indicated above. Address <br />ranges will not be accepted -- for additional assistance with file addresses, contact the END. Applications received after <br />r 7 3:00 pm will be processed the next business day. <br />The EHD Will notify the applicant if any EHb files exist. An appointment for review 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 />z Sr 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 />.Any file not returned in the sante condition as released will be reorganized by FHD staff at the expense of the applicant <br />Future file reviews by the same applicant may require a $98.00 deposit prior to review. <br />EHD USE ONLY <br />e:s <br />"D 48.08 WEB 8I8I2DO7 <br />r•L\ <br />