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12/144//j2006 �08�59 13107982841 PAGE 02 <br /> SAN JOAQUIN COUNTX EHD LOG NUMBER <br /> DEC 1 4 2006 ENVIRUNMENI'AL HEALTH DEPARTMENT <br /> ENVIRONMENT HEALTH 304 East Weber Avenue,3rd Floor, Stockton, CA 95202-2708 <br /> PERMITISERVICES Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.6jgov.org/chd �J <br /> 1� <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT; foltile <br /> vtet� II CVje;3 BUSINESS/AGENCY:_EZ CC)n5jjj-tajjtS <br /> ADDRESS: (2Si1O�O cCc1 <br /> � m(_VO.D iablo IALIty Qi- CKC � !?145M <br /> PHONE(1): PHONE(2): FACSMIIILE, rTS <br /> ggf4'Z895 <br /> TENTATIVE•APPOINTMENT DATE: ASAP Tom: <br /> (PIGe"allow 10 business days from data of application submldal-'Tmtef m only,must be confirmed) <br /> 173 CHECK BOX TO EXPEDITE REQUEST-$45.00 FEE(CASH OR CHECK ONLY]-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE —t2yZLV <br /> Electronic Information: List❑Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> StrcM 11 Sheat Name City VQ Unit 1 <br /> 1. 400 "T-0 i <br /> 2. ❑ unnz <br /> )/J <br /> \ <br /> yC I� 3, I <br /> 4. Unit 3 <br /> 5. <br /> 5, urn a � <br /> 7. <br /> ❑ 0 <br /> units <br /> s. <br /> 10. Umn s <br /> Specific Date Range Of Information Requested:From q y 4 to f'nesavt-4- ' <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> y N <br /> W UNDERGROUND TANK(UST)CLEANUP SDE(LOP) ❑HOUSING ABATEMENT XSOLID WASTE FACILITYNEHICLE <br /> IZOTHER CLEANUP SITE(NON-LOP) M FOOD FACILITY )ff WASTE TIRE Rv` <br /> UNDERGROUND TANK(MONITCRING(REMOVAL) ODos KENNEL C3 DAIRY <br /> NA=ARDOU9 WASTE GENERATOR E3 CHICKEN RANCH , -LWA31TWAMR TRFATMENT PLANT <br /> C TIERED PERMITTED FACILrrY O MOTEL/HOTEL O PUMPER TRUCK(YARDICHEM TOILETS <br /> Cl TATTOO/BODY PIERCING ❑PWUSPA ❑LAND USE APPLICATION SITU <br /> ❑MEDICAL WASTE FAce try ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT REcoRDS ARE AVAILABLE FOR REVIEW . MONDAY-FRIDAY 6:00 AM-6:OOPM - EXCLUDING HOLIDAYS. 00 <br /> 1. List up to ten addresses in the space above. Select the types)Of files from the list above by checking the appropriate <br /> box(es). At[Bast one file type MUST be selected. Fax to(2091464-0136 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 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 EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$95.00 deposit prior to review. <br /> EHD USE ONLY <br /> DN aeon PH9/2008 <br />