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03/23/2007 Oe:11 7704410 CRA PAGE 01/01 <br /> OFIVE SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALT11 DEPARTMENT <br /> 304 East Webor Avenue, 3"1 Floor, Stockton, CA 95202-2708 <br /> L-1 Itelephone; (209)468-3420 Fax: (209)464-0138 Web:WWV;.sjl;ov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION m ... ... <br /> APPLICANT: OFlN 14VFF —BUSINESSIAGENCY: <br /> ADDRESS: /Y/2 Oqk b rpoK fili.,e Fv,'ILe I to P c&os 5 / 67A 300115 <br /> PHONE(1): 7,7L'_'44//-0O27 —PHONE(2): 770--Z45 _3 81 (—FACSIMILE:. 770-</'//-Z 0$o <br /> TENTATIVE*APPOINTMENT DATE: /VO4- Time: <br /> (Please allow 10 business days from dais of application Submittal.*Tanratln only-must be cDnfirmad) <br /> 13 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: ElList L]Map-Description: <br /> FILEADDRESSEND USE ONLY <br /> 1�� Street V Street Name City 11 unit I <br /> 1. 321 Spracicles Arenve I'lat,ie4o, _:,)j <br /> 2. Unit2 <br /> 3. P <br /> 4. r,,(7 Unita <br /> np <br /> LL3 LL9 7 unit 4 <br /> 7. <br /> ❑ unit5 \ <br /> 8. <br /> 9. <br /> unite <br /> Specific Date Range Of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> DQ UNDERGROUND TANK(UST)CLEANUP SITE(Lop) 13 HousiNo AaATEmEKT C3 SOLID WASTE FACILITVVEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) 0 FOOD FAkILTry 0 WASTE TIRE <br /> _1UNOERGROUND TANK(MONTroniNGIREMmAL) t!l DOG KENNEL 0 DAIRY <br /> HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH Cl WASTLWATERTFtgATMENT PLANT <br /> 0 TIERED PERMITTED FACu-irr 0 MoTrLIHOTEL 11 PUMPER TRUCKWARDICHEM TOILETS <br /> 0 TATTocdBovy PirRcme M PDOLJS;PA C3 LAND USE APPLICATION SIM <br /> 13 MEDICAL WASTE FACILITY 13 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MOMbAY-FRIDAY EI AM-5:00PM - EXCLUDING HOLIDAYS. <br /> 1. List up to ton 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(2091464-0138 or mail to the address Indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,Contact the END.Applications received after 41111111111111110 <br /> 3:00 pin will be processed the next business day. <br /> 2. The END will notify the applicant It any END files exist An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The flies 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 END 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 /> END USE ONLY <br />