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03/23/2007 08: 11 770441200 CRA <br /> • � PAGE 01/01 <br /> IyA7�Rp-6EIVE� ✓ ' > > <br /> SAN JOAQUIN COUNTY EHD L00 NUMBER <br /> fru, a =i 1 <br /> 0J7 ENVTRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3'"Floor, Stockton, CA 95202-2708 <br /> 4 I)Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgoy.org/ebd <br /> �rlit�I�l �lu�) p ( A1, '9fw In <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: BUSINESSIAGENCY: <br /> ADDRESS: Jyl? 04'<bra0K A.Ydt S"O' eIto, /,roReRosS , 6A 3oog3 <br /> PHONE(1): 770_yy/-002'7 PHONE(2): '77o-Z45 ­391 '-FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE: /vex <br /> (Please allow 10 business days from date of appllcauon submittal.•Tentallve only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$95.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑List❑Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑ Unit t <br /> 1. 32t SprccKle� Are�ue �"tar,feca H J <br /> 2. �r1 �-Pi� ❑ UnR 2 <br /> 3. <br /> 4. <br /> �Ir.`r Unb3 <br /> � n� / <br /> S. i3 0 Y <br /> :_. <br /> Unna n <br /> 7. 0 9 20 <br /> ❑ Unit s <br /> 8. <br /> 9. 0 Unita SIR <br /> Specil V V-A sd:From to <br /> DNMENTAL HEALTH DEPARTMENT FILES <br /> JiQ UND ❑HOUSING ABATEMENT ❑SOLID WASTE FACILI YlVEHICLE <br /> OTH ❑FOOD FACILITY M WASTE TIRE <br /> NNE r]DDG KENNEL 0 DAIRY <br /> HA2ARDOD6 wAsiOCHICIGiN RANEK 17 WA0TEWATERTREATMEHT PLANT <br /> C3 TIERED PERMIrrEO FAcnm ❑MOTEJHOTEL 0 PUMPER TRUCKIYARDICHEM TOILETS <br /> O TATTDOIBODY PIERCING ❑PDOJSPA ❑LAND USE APPLICATION SITES <br /> El MEDICAL WASTE FACam ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 8:00 AM-S:ODPM - EXCLUDING HOLIDAYS, <br /> 1. List up to tan 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(2091 ase-0138 or mall to the address Indicated above. Address <br /> ranges will not be accepted-far additional assistance with file addresses,contact the EHD.Applications received after 411111111111M <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 mcaipt 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$95.00 deposit priorto review. <br /> EHD USE ONLY <br /> RHO 4941 BnUR005 <br />