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07/02/2007 MON 16:47 FAX Z001/001 <br /> DATE RECEIVED _ EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> i `J`,, 600 E. Main Street, Stockton, CA 95202-3029 <br /> Telephone:(209)468-3420 Fax: (209)464-0138 Web;•www0 <br /> slgov.org/e V — <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: I'Ne LLQ I1 he I, <br /> 13U31NE55lAGENCY: L[kS CSG/}D&YC`1-1 Ulm <br /> ADDRESS; C�c1fG'L� C,� Ci CZkc:, c <br /> y 1�r SLt i' I c- Sct I-L"t17,2r �r 0,4 9S� 33 <br /> PHONE(1); "IIIc— C4V;Z--- t 11�{; PHONE(2):"(L--�-1`'I— 3�}(p FACSIMILE: IL.:— t.y�lci ' <br /> TENTATIVE'APPOINTMENT DATE: ')tt'(x i.1 2C, O Time: 1 ' a <br /> (Please allow 10 buslnoss days from dato of appllcitlon submittal--TanM6ve only-muet be co Irmed) AFD <br /> Cl CHECK BOX TO EXPEDITE R QUEST-595.00 FEE(CASH OR CHECK ONLY)•REQUEST PROCESSED I 7 <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List❑ Map–Description: <br /> .,._-. FILE ADDRESS EHD USE ONLY <br /> Streatp Street Name City 13 unit,1. CG L.c r SM HW, ART <br /> 2. <br /> 3. <br /> 4. Unh s <br /> 5. \\ <br /> 6, Unit <br /> T. <br /> g, ❑ Unit 5 <br /> 9. <br /> 10. Unit 6 <br /> Specific Date Range of Information Requested:From /'t'-L to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> G!"GNDERCROUND TANK(UST)CLEANUP SITE(LOP) O HOUSINGAEATEMENT MrSOUD WASTE FAoLITYIVEHICLE <br /> BOTHER CLEANUP SITE(NON-LOP) 13FOOD FACILITY eWASTETIRE <br /> PNORROROUND TANK(MONITCRINWREMOVAL) ElDOG KENNEL :3 DAIRY <br /> HAZARDOUS WASTE GENERATOR CI CHICKEN RANCH 5]'WASTEWATER TREATMENT PLANT <br /> DrTIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCIWARDICHEM TOILE,g <br /> 0 ATTOOBODY PIERCING M OOLISPA t L 6CAND USE APPLICATION g}r�ITES <br /> MEOICAL WASTE FACILITY Ve THER(PLEASE SPECIFY) �-P+C r I GTC. 14=G4in` VU C(1 <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILAaLE FOR REVIEW- MONDAY-FRIDAY 8:00 AwSAOPM . 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)464.0138 or mail to the 210dress 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 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 now 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$95.00 deposit prior to review. <br /> EHD USE ONLY - <br /> enu�eae enerzox,.,n <br />