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From: 10/2612011 09:37 #646 P.001 /001 <br /> EHD LOG NUMBER w <br /> SAN JOAQUIN COUNTY ,JL^ <br /> x: 1 311 ENVIRONMENTAL HEALTH DEPARTMENT /�� <br /> 600 East Main St. Stockton, CA 95202-3029 (� 1i <br /> ephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd J <br /> -01R.j� N PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: A &A <br /> k lcwov hl (,g,y, BUSINESS/AGENCY: COVOU V, Lu,0 6T1 <br /> ADDRESS: ,7Z+ A,4,Nb n ZI CITY/STATE/ZIP: YrOlJ�4 �,.�29101 <br /> PHONE (1): (621 --R3O-(2-4i PHONE(2): 9Si' -1444- -731.43 FACSIMILE:_Ip2- . it�O- Qjl <br /> TENTATIVE*APPOINTMENT DATE: t<)Y,y,�',;,,5 Time: �.e�,rQ,'nl <br /> (Please allow 10 business days from date o pplicatl submittal-*Tentative only-must be conRrm d) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$122 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> U <br /> SIGNATURE OF APPLICANT \ DATE 10I'Z0 1) <br /> Electronic Information: ❑ List❑Map—Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street Street Name City Unit <br /> 9SO14 o ( oES ,No GO t <br /> z. D-itz <br /> 3. <br /> 4. Unit 3_ 1� <br /> 5. <br /> 6, <br /> Unit 4 <br /> 7. <br /> a. <br /> Unit 5 <br /> 9. <br /> 10. unN <br /> Specific Date Range of Information Requested: From t 0/1 1 t(— to— <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT 2'SOUD WASTE FACILRYIVEHICLE <br /> THER CLEANUP SITE(NON-LOP) ((���� ❑FOOD FACILITY ��NASTE TIRE (� <br /> UNDERGROUND TANK(MONRORINGIREMOVAL)k - El DOB KENNEL AIRY to ?I—II <br /> HAZARDOUS WASTE GENERATOR CHICKEN RANCH WASTEWATER TREATMENT PLANT J <br /> TIERED PERMITTED FACILITY D( ❑MOTELIHOTEL PUMPER TRUCKNAROICHEMICAL TOILETS <br /> ❑TATTOOMODY PIERCING ❑POOLISPA J6—j.ND USE APPLICATION SITES <br /> '�;j MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AMS: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)464.0138 or mail to the address 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 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 EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$122 deposit prior to review. <br /> END use ONLY <br /> END n.os <br /> ovzwlo <br /> "(�'U�W1k Dov <br /> Vora ckY® vuSeC& slJco n <br />