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MAY-09-2011 MON 03;49 PM FAX NO. P. 01 <br /> RECEIVED <br /> EHD LOG NUMB <br /> D w=- E@011 SAN JOACIUIN COUNTY N ` <br /> ENVIRONMENTAL HEALTH DEPARTMENT n <br /> ENVIRONMENTAL HEALTH 600 East Main St, Stockton, CA 95202-3029 <br /> PERMIT/SERVICES Telephone: (209) 468-3420 Fax: (209)464-0136 Web:www,sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> 13USINESSIAGENCY:Df nlcC� <br /> APPLICANT: r — 1 ^__. "cin A w�0 <br /> ADDRESS: 5 <br /> rn ^'M'�n� Sa anitiFlo;L-- ~ CITYISTATE/ZIP:, <br /> � O2 :�Ij�SgFACSIMILE: <br /> PHONE(11): S PHONE Lj <br /> Time: <br /> TENTATIVE"APPOINTMENT DATE: ii atlon submittal-•Tantatma only-must be confirmed) <br /> (Please allow 10 business days from date of app ,; <br /> CHECK BOX TO EXPEDITE REQUEST.$122 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DVS <br /> DATE <br /> SIGNATURE OF APPLICANT-- <br /> Electronic Information: ❑ List ] Map-Descnption: <br /> EHD USE ONLY <br /> FILE ADDRES5, L <br /> r7. <br /> treet p street Name <br /> _ r_ city.— L �fi�N0l�7t 1 <br /> I Uy � <br /> MC- I-,�ei�.0 nit 3- .. Una 4 <br /> Units <br /> — � to ✓ <br /> SpsciNO oats Range of Information Requested: From _—.). <br /> ENVIRONMEN rAL HEALTH DEPARTMENT FILES SOUO WASTE FACILNYNiSHIGLE /I <br /> NDERGROUNO TANK(UST)CLEANUP SRE(LOP) C. HOUSING AaATEMENT WASTE TIRE <br /> OTHER CLEANUP SITE(NON-I.OP) C. FOOD FACILITY ❑DAIRY <br /> UNDERGROUND TANK(MONRORINGIREMOVALV CI Doo KENNEL Ay yfA�RTREATMEN TPLANT <br /> `RFIAZARDOUS WASTE GENERATOR Ot ,Y \ C.�CHICIU'.N RANCH UPUMPER TRUCKIYARDICHEMICAL TO S <br /> TIERED PERMITTED FA0ILITYCA� [.I MOTEL)HOTEL ND USEAPPLICATION:iITE5 <br /> C 1 TATTOOIBOOY PIERCING C.l POOLISPA <br /> ❑ MEDICAL WASTE FACILITY [,]OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLC FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:OOPM(ExCLUDING HOLIDAYS) <br /> Im the list above by ng the appeopristO <br /> 1. L.Ist u0 to ten addresses i"uMUST be selected Fact ht<ry2091 bBJ�.•'.•G138 or maPe(s)Of files fro il to the address Ind ctntetl abo eAddress <br /> hex(es). At least one file type —�--�-- <br /> ranges will not be accepted-for additional assislanca 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 far review will be confirmed approxima�eyrteren 00) <br /> days after receipt of application. The files will be held for a maximum of five business days for review. Appo <br /> should be scheduled accordingly. <br /> 3. A file that is actively being worked on by EHD sl;1ff may not be Immediately avallable 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 n,eased will be reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may niquire a$122 deposit prior to review. <br /> n Jl UREONLY .G <br /> " ik)I Y,, vr�Q, (1 "- /1lQy)10 <br /> GQ /r 2s n _n U i ylb(l Wt � <br /> 07149110 <br /> sae secs <br />