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From:James Robinson Fax:+1(208)740-4303 To: Public File Review Regl Fax: +1(209)464-0138 Page 1 Of 1 8/14/2009 12:51 <br /> pAT€REIIyEO„1��� SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> AUG 14 2009 600 East Main Street, Stockton, CA 95202-3029 / <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.od 1/ <br /> ENVIRONMEN t HEALTH 4 <br /> () 3 <br /> PERMIT/SERVICER PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Lames Robinson _ BUSINESSlAGENCY: JR Squared Consulting, Inc. <br /> ADDRESS: PO BOX 1744 City/State/Zip Valley�tins, CA 95252 <br /> PHONE(t): 209-772-3841 PHONE(2): Cell_Z09-6 2-5445 FACSIMILE: 209-740-4303 <br /> TENTATIVE`APPOINTMENT DATE: AnDust 20, 2110 . Time: 3 Pm <br /> (Please allow 10 business days from date of application 1ju 41t a,,,�Ix*T a only-must be confirmed) <br /> X)$ CHECK BOX TO EXPEDITE REQUEST-5105 FEE(CASH OR CHECK ONJ ” <br /> O ESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ` TE 08/14/09 <br /> <i/ <br /> Electronic Information: ❑List❑ Map–Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name Cl ty <br /> 1• 1024 Mellon Avenue Manteca ❑ Unl(i; , <br /> an eco <br /> 3. 400 Indust 'al Park Drive Manteca <br /> 4. 560 Indu -ial Park Drive Manteca I,)DdYJ' hb yf Unit 3 <br /> S. 551 Carne ie St Manteca <br /> � 1 <br /> s• 555 Carne a St Manteca r t ^� Unit a <br /> 7. ,u .7,1 <br /> g- ❑ Unit 5 <br /> 8. <br /> 10. — ❑ unit 6 <br /> oSpecific Date Range of I rrnation Requested: From to // <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES 1-L �e1P5 <br /> IQ UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 13 HOUSING ABATEMENT ❑SOLID WASTE FACILITY/VEHICLE ,, „ <br /> X171ufi <br /> M OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY WASTE TIRE I{3- <br /> p;UNDERGROUND TANK(MONITORINUREMOVAL)0l ❑DOG KENNEL 171 DAIRY <br /> �NWMA1��, <br /> 1v[HAZARDOUS WASTE GENERATOra7, 13 CHICKEN RANCH E3 WASTEWATER TREATMENT PLANT <br /> YY TIERED PERMITTED FACILITY ❑MOTEL/HOTEL In PUMPER TRUCK/YARD/CHEM TOILETS <br /> El TATTOO/BODY PIERCING ❑POOL/SPA ❑LAND USE APPLICATION SITES <br /> 13 MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 8:00 Am-5:00PM - 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 /> bOXCes). At least one file type MUST be selected. Fax to(209)464.0138 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 END 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$105 deposit prior to review. <br /> EHD USE ONLY <br /> Ago ne 0,lby U2192 51 1Y i 5, <br /> yr 4 <br /> 5 11c,17 M Q7 q5 s° ; <br /> 2 / <br /> END48-06 - PUBLIC RECORDS RELEASE APP FORM <br />