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�1�Froo���m::MMaa�rcu�7sr�H. Bole & Asso*es 530+633+0119 12/2009 16:12 #140 P.001 <br /> MOWED�Ot�lP`dyd���fH�D EHD LOG NUMBER <br /> IJ It L�LI•UI SAN .IOAQUIN COUNTY <br /> Gil O 7 2009 ENVIRONMENTAL HEALTH DEPARTMENT h <br /> 600 East Main Street, Stockton, CA 95202-3029 U <br /> ENVIRUNMtNT HEALTITI�lephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.o <br /> 4 PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION p"I, <br /> APPLICANT: . C' /h BUSINESSIAGElNCY:J/2za'/i �,-� <br /> ADDRESS: /05/ ArOck !//-/J-C� City/State/Zip l�x1 'Z //0,14 / <br /> PHONE(1): ,SO)✓-63-?-Oil-7 PHONE(2):,�O_CZ/S— (a 6-)�?4DIW id FACSIMILE: =)s'O '(0.3.3`d//9 <br /> TENTATIVE`APPOINTMENT DATE: ���7 /{1u,^t Time: 9.3U <br /> (Please allow 10 business days from date of application submittal-'Tentative only-must be confirmed) <br /> l� CHECK BOX TO EXPEDITE REQUEST-$105 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 of Sweat Name City e-❑ Unit 1 <br /> 1. � C/ (7J a 0 G� D/1 <br /> / 2• g/.;1.5— /z , �/ U 1 15SN it2 <br /> CJ 3. f f _A), R \ <br /> 4. 79/ <br /> �l <br /> 5. <br /> 6. 7.S— gT a t`),NO — <br /> 7. /( <br /> O L' ST Ota,Ngwil3w 5FID Unit <br /> B. - <br /> 9. / Unit6 <br /> 10. p <br /> Specific Date Range of Information Requested:From to �1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES 0- <br /> u'',,�/UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT SOLIO WASTE FACILITYNEHICLE 7 <br /> V <br /> VTHER CLEANUP SITE(NON-LOP) 0FOOD FACILITY E3 WASTE TIRE <br /> Q-tf GROUND TANK(MONITORING/REMOVAL) O DOG KENNEL 0 DAIRY ^ \ <br /> I�AZARDOUS WASTE GENERATOR r3 CHICKEN RANCH 0 WASTEWATER TREATMENT PLANT <br /> IM TIERED PERMITTED FACILITY 0 MOTEL/HOTEL 13 PUMPER TRUCKIYARDICHEM TOILETS <br /> TATTOOIBODY PIERCING 17 POOUSPA 13 LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 6:00 AM-5:00PM - 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$105 deposit prior to review. <br /> EHD USE ONLY <br /> =jN — <br /> EHD 48.06 8/04/08 PUBLIC RECORDS RELEASE APP FORM <br />