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11-Jan-2006 01:25pm From—Youn§dahi sultinc Group, Inc 916 933 6482 T-131 P.001/001 F-779 <br /> L _ <br /> TE RECEIVED EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue,3rd Floor,Stockton,CA 95202-2708 rw 9 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgOv.ore ebd �/ I <br /> i PUBLIC RECORDS RELEASE APPLICATION <br /> APPucANT: L�2L>!I`6e S ii-4 ,e / BUSINESSIAGENCY: lloa x&'61 0'-LC 4177}1!} <br /> ADDRESS: 2 ave-A r-t Dorf 5,r7& ;t/ <br /> PHONE 11): (9/(T) 9-3 J- i*3 3 PHONE(2):�QI�O 2 11/7^a6 1a( FACSIMILE• / .�'-(7 Y�� <br /> TENTATNE*APPOINTMENT DATE: Time: <br /> (Please avow 10 buslr ess days from date of application submittal-•Terrane only-mvst be confirmed) <br /> aR/CHECK BOX TO EXPEDITE RE T-§93.00 EE( R CH K ONLY)-REQUEST PROCESSED M3 BUSINESS&. - <br /> SIGNATURE OF APPLICAN DATE /// Q <br /> - � 6 04 <br /> UNIT DISTRIBUTION Unit 2 0 Unit 3 0 Unit 4 13 Unit 5 0 Unit 6 O Other(cicctroniclllstslmaps) <br /> FILE ADDRESS EHD USE ONLY <br /> Street SerestNamo city <br /> 1. loo Chas%t W - 67ty-f y I <br /> 2. .SD Ctict�-Tr K <br /> 3. D 3 ri V <br /> 9. <br /> 110- 1 1 <br /> Specific Date Range of Information Requested:From " <br /> 1 ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> Ii/ NUERGRoumc,TANK(UST)CLFJWUP SUE(LOP) O HOUSING ABATETAEtu `/SOUR WASTE FACILITYNEH E <br /> ��)THFR CLEANUP SmE(NON-LOP) ❑FOOD FAcie In WASTE TIRE <br /> F NDERGR0UND TANK(MONrrORMGIRExOVAL) 0 DOG KENNEL 13 DAIRY <br /> HAZARDOUSWASMEGENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PUNT <br /> 0 TIERED PERMITTED FACILITY 0 MOTWHOTEL ❑PUMPERYRUCK/YARDICHEM TOILETS <br /> ❑TAnooIBom PIERCING ❑POOLISPA ❑L,wo Usr APPLICATION SUES <br /> 0 MEDICAL WASTE FACaRY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMU RECORDS ARE AVAILABLE FOR RPAEW . MONDAY-FRIDAY 8:00 Am-5:00m - 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 <br /> appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address <br /> indicated above. Address ranges will not be accepted-for additional assistance with file addresses, contact <br /> the END.Applications received after 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 <br /> approximately ten(10)days after receipt of application. The files will be held for a maximum of fire business <br /> days for review. Appointments 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 <br /> application may be 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 <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> Elio."o4ns <br /> 1/INRs <br />