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FROM ERAS Envlvenm nxal. Ir.c. <NON)JVL 13 2009 10:03/ST. 10:03/No.7600000327 P l <br /> r I <br /> SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> uu uu ENVIRONMENTAL HEALTH DEPARTMENT <br /> JUL i 3 20L9 600 East Main Street, Stockton, CA 95202-3029 / <br /> 007 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgiDv.or e // <br /> ENVIRONfi+'ErJ? #1EALTH / r <br /> "IT(c�RVlCE� PUBLIC RECORDS RELEASE APPLICATION l(( I A9 <br /> APPLICANT: BUSINESSIAGE C jp,17 <br /> ADDRESS: I �^1 qPD CkylStatemp (+ <br /> PHONE(1): S(L)'a y !' 1 t7 K-30;-PHONE(7 . FACSIMILE: J (6 ^tr 8 - <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from tlate of application submlW l-•Tentative only-must be ranfimlad) ,y ,'� <br /> CHECK BOX TO EXPEDITE REQUEST- 103 F (CASH CHECK ONLY)-REQUEST PROCESSED INA BUUSINESS DAYS <br /> SIGNATURE OF APPLICANT "� DATE <br /> Electronic Information: ❑ List El Map-Description: <br /> FILE ADDRESS END USE ONLY <br /> Strata S tName City <br /> 1' tj <br /> k P.n 1 h <br /> 2. kyaniLe- N co/SP Unit <br /> 3. H H \ <br /> 4, Unit 3 <br /> b U. Unit <br /> 7. r <br /> B ❑ Unit 5 <br /> kk <br /> 9. <br /> 10. i _— ❑ Unit e <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES �I�S �/ <br /> NDERGROUNO TANK(UST)CLEANUP SITE(LOP) ❑HOUSING AaATEMENT O SOLID WASTE FACILTTYNENICLE I' � 1 <br /> P/y.��'O�'�THER CLEANUP SITE(NowLOP) ❑FOOD FACILrrY E3 WASTE TIRE 1�1.�, 1 3 - 0 <br /> �1W,,�A�/"NDERGROUND TANK(MONITORINGIREMOVALj� ❑DOG KENNEL ODAIRY <br /> /+TIATARDOU3 WASTE GENERATOR C— 13 CHICKEN RANCH 17 WASTEWATER TREATMENT PLANT <br /> 13 TIERED PERMnTEO FACILITY ❑MIOTELIHOTEL ❑PUMPER TROCIUYARDICHEM TOILETS <br /> ❑TArTOD/BOOY PIERCING O POOLISPA 0 LAND USE APPLICATION SOEa <br /> ❑MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REvirw- MONDAY-FRIDAY a:00 AM-S:OOPM - 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 /> box(es). At least one file type MUST be selected. Fax to(209)4640138 or mail to the address indicated above Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the END. Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The END will notify the applicant if any END 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 END 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 END staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$105 deposit prior to review. <br /> END USE ONLY <br /> END 48-06 8/04A)6 PUBLIC RECORDS RELEASE APP FORM <br />