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May. 3 . 2007 813A Ad aSAN JOAQUIN COUNTY ced GeoEnvironT,entaI No. 8774 F. 1 <br /> DAT EHD LOG NUMBER <br /> (� Z �D <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> MAY 3 1 2007 304 East Weber Avenue, 3rd Floor, Stockton, CA 95202-2708 <br /> Telephone: (209)468.3420 Fax: (209)464-0138 Web: www.sjgov.org/e <br /> ENPE ONi'�SERVICESB <br /> PUBLIC RECORDS RELEASE APPLICATI�O°N { f <br /> APPLICANT: n-'V DE IC�"�` BUSINESS/AGENCY; hdVQ,n,Q& �XEO EnvT`YOrIW.u. ,�,1�(r<.4. <br /> ADDRESS: '9) I ��kA"W "kO <br /> PHONE III: 141�t L10-tolk PHONE(2): O"lI"��-•r7Sr7l� FACSIMILE: x{0-1 ilt <br /> TENTATIVE"APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal•"Tentative only•must he co <br /> Q CHECK BOX TO EXPEDITE RE T•S 'b0 FEE SH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSIN AAlf <br /> SIGNATURE OF APPLICANT DATE 5-31-07 <br /> v <br /> UNITDISTRIBUTION ❑ Unit L3 Unit a Unita 0 Unit 0 Unit ❑ Unit ❑ Other(slectronldllsts/maps) <br /> FILE ADDRESS EHD USE ONLY <br /> Street% Street Name City <br /> • a60$U torn __....__.. Yn N NFF <br /> _. . <br /> `I� ;100,90 Ynkbr L6_--- rn r o CI <br /> 5. R------------- <br /> 'aft %am <br /> 7. - — <br /> 8. <br /> 9. 1 1 _....._—.. awl <br /> 110. 1 1 <br /> Specific Date Range of Information Requested:From 1.Q£SO to 01-Pb�+ti <br /> �, <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> 4t UNDERGROUND TANK(USI)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITVIVEHICLE <br /> ❑OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY 0 WASTE TIRE ' <br /> i)a UNDERGROUND TANK(MGNITORING/REMOVAL) ❑ DOG KENNEL 171 DAIRY <br /> 9CHAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH O WASTEWATERTREATMENT PLANT <br /> Q TIERED PERMITTED FACILITY ❑ MOTELIHGTEL 0 PUMPER TRUCK/YARO/CHEM TOILETS <br /> O TATTOOIBODY PIERCING ❑POOL/SPA ❑LAND USE APPLICATION SITES <br /> 13 MEDICAL WASTE FACILITY ❑ R ESPECIFY) ry <br /> WELL AND 8EPTIC PERMIT RECORDS ARE AVAILABLEE FORFOR REVIEW <br /> - MONDAY-FRIDAY 6:00 AM•S:OOPM EXCLUDING HOLIDAYS. <br /> I. 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(2091464-0138 or mall to the address <br /> indicated above. Address ranges will not be accepted-for additional assistance with file addresses, contact <br /> the EHD, 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 five 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 D <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 /> EHD 48.02-008 <br /> VINIM <br /> 3u33 <br />