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APR 16,2008 12:22 000-000-00000 page 1 <br /> iF"— <br /> I—f�7'ATH IF€dlyD r <br /> SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> APP, 1 6 1008 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, 38 95202-3023 <br /> ENUtr'U V 49c I � t iLi rTelephone: (209)468-3420 Fax: (209)464.0138 Web: Wwwsjgov.D hq 5k <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: r T (' BUSINESSIAGENCY: <br /> ADDRESS: 3 c � Ll <br /> PHONE(t): r PHONE(2)c FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE:I I_ y 1 , 2069, `�Time-� <br /> (Please allow ten business days from dote of pilin n submetsl-^Tentative only-moat be confiRned) <br /> � CHECK Box TO EXPEDITE REQUES . F (CASH OR CHECK ONLY)-REQUEST PROCESSED IN THREE BUSIN SS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Inforniahon: E]List[] Map-Description: <br /> _ FILE ADDRESS EHD USE ONLY <br /> Street>F StnTat Nemo - <br /> \U City ❑Unit1 <br /> ri <br /> ezLt 6t, <br /> �'+ v9� ._ . _ AO ❑Unit 2 <br /> JJ \V <br /> Erna <br /> 'I r .� /Y/'P.l•t-1 n-vl.�' (� nit 4 <br /> a L_— w FYI 5s aZ <br /> 1 11 unit 6 <br /> 7 G J N' ��,r/�.50✓1 rj'ri I��' X31 DC�GtAvt OZ <br /> Specific Date Range of Information Requested:From f-P C'q 4 — <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES �`� o_S �✓ <br /> UNDERWOUND TANK(UST)CLEANUP SITE(LOP) (3 HOUSWo ABATEMENT �Cp'SOLIo WASTE FpcwTvNENICLE <br /> �OTHER CLEANUP SITE(NON-LOP) ❑FDOD FACILITY � rSOLIV TIRE <br /> •`6UNDERGROUNO TANK(MONITOFUNDIREMOYAL) ❑Doc KENNEL El DAIRY <br /> 4AZARDOUS WASTE GENERATOR C3❑CHICKEN RANCH �WA5IFWATER TREATMENTPLANT <br /> C3 TIERED PERMITTED PIERFACICING <br /> TV�J. O MOTELMpTEL O PUMPER TRUCK/YARD/CHEM TOILETS <br /> El MEDICAL WAS PIERCING 0 POOUSPA to LAND USE APPLICATION SITES <br /> O MEDICAL WASTE FACILITY ❑OTNER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW.MONDAY-FRIDAY 8:00 AM-6:00ps,• EKCLU fNC HOUOAYS <br /> 1. Ust up to tan addresses in the space above. Select the types)of Ries from the list above by checking the approfiat, <br /> box(es). At least one Ole type MUST be Selected, ax fo 209 -073 r m o the ova dre , Address ranges will <br /> not be accepted-fort business <br /> assistance With Flla addresses,contact the EHD. Applications received after 3:00 pm will <br /> be processed the nest business day. <br /> 2. The EHD will notify the applicant If any EHD files exist. An appOlnhnent for review will be confirmed approximately ten <br /> days <br /> after receipt of application. The files will be held for a maximum of Ove business days for review. Appointments <br /> should be scheduled accordingly. <br /> 3. A file that Is actively being worked on by the EHD staff may not be Immediately available for review. A new application <br /> may be submitted when the file Is available. <br /> 4. Any file net 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$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> 6J 3N5zg <br /> Etloaar lazrroi _ <br /> PUaLIC RECORDS RIEEASE APP FORM` <br />