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08/19/2010 08 34 FAX 91685291" Geocon Consultants laoOl/001 <br /> DATE RE\\21i0 EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-3029 ttL66 (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ hd 71A <br /> Oj� <br /> ��p .�f�l PUBLIC RECORDS RELEASE APPLICATION <br /> „APPLICANT; BUSINESS/AGENCY:_GLL-)CA�ti1 rwgt�� yti T <br /> ADDRESS: _. 2U940 00LJ> t_l� . ' r 17R CfTY/STATE0P:�yp�' CA Q C�9L4Z <br /> PHONE(1): %(a) $5y_cj I ( S PHONE(2):��-6�)(o S FACSIMILE:0(c 857 I <br /> TENTATIVE*APPOINTMENT DATE: 8-Zy.(O - Time: I ;)a <br /> (Please allow 10 business days from data of;glWtlon subminal-•TentaUm only-must be coMlrm ill <br /> CHECK BOX TO EXPEDITE REQUEST-$122 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIG ATURE OF APPLICANT ( DATE <br /> Electronic Information: ❑List[]Map-.Description: <br /> FILE ADDRESS EHO USE ONLY <br /> StrestR Street Name City <br /> _ nh7 <br /> OI 1 (�vra r Sit e.4Lyt,,1 NO ND n <br /> y, <br /> o0.Ylt � nx 2 <br /> 3. i s Y r ncK u �y <br /> a. a�A dtiD ma u 'L <br /> 5. µ nit3 <br /> a. u ES,co/ti <br /> T: nN 4 <br /> e. <br /> 9 ❑Units <br /> SclflNrDs6a.Ri�n9 fdifne Requested: From to <br /> ENVIRONMENTAL,HEALTH DEPARTMENT FILES \ <br /> IUNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT S 5000 WASTE FACI <br /> OTHER CLEANUP SITE(NON-LOP) C3 FOOD FACILITY WASTE TIRE � `L <br /> UNDERGROUND TANK(MONROPoNGIREMOVAL)� El DOG KENNEL DAIRY 1 '��y k <br /> HAZARDOUS WASTE GENERATOR A El CHICKEN RANCH WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILRYP' ❑MOTELIHOT L PAMPER TRUCKIYARD/CHFMCAL TOILETS O <br /> 'TATTOO/BODY PIERCING ❑POOLISPA 0 LAND USE APPLICATION SITES <br /> P MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AIA-6:00PN E%CLUORiO HOLIDAYS) <br /> 1. Ligit up to ten addressee In the space above. Select the type(s)Of files from the list above by checking the appropriate <br /> box(es). At least one RIO type MUST be seieeted. Fax to(2091494.13130 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 /> 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 recelpt 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 EMD staff may not be Immediately available 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 EHO staff at th s f the applicant. <br /> Future file reviews by the same applicant may require a$122 deposit prior to review, .7 <br /> eco use onLr T <br /> Z <br /> r <br /> to <br /> MHO ee ten <br /> erneli <br />