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' 62/63/2011 23: 27 866260^x06 SIERRA INS & FT" SVS PAGE 02/02 <br /> 1 <br /> FF1D LOG NUMBER <br /> ° VIIECEIVED SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> j 0 4 2011. 600 East Main St. Stockton; CA 95202-3029 L <br /> Telephone: 468-3420 Fax: (209) 464-0138 Web: WWW.Sj90V.Org/ehd <br /> (209) <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:John McCann _ BUSINESS/AGENCY:John McCann <br /> ADDRESS: PO Box 2212 CITYISTATE2IP:Lodi,CA 95241 — <br /> PHONE (1): 209-339-1825 PHONE (2):209-A06.4427 _ FACSIMILE:866-26441606 <br /> TF_NTATIVE"APPOINTMENT DATE: 2/1412011 Time: 10am <br /> (Please allow 10 business days from date of appllcation Submittal-"7eritHSVt4 only-must be confirmed) <br /> [�CHECK BOX TO EXPEDITE REQUE S $12 EE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS BAYS <br /> SIGNATURE OF APPLICANT _ DATE 6.2- o <br /> Electronic Information: rWst L] Map–Description: <br /> FILE ADDRESS EHD USE ONLY <br /> *Street# StreetNameCity Unit 1 <br /> 1. East Hwy 26 Linden �1`j iL' �'(�I 3�/�2 µ� p Unit 2 <br /> Unit 3 /I't <br /> 4. <br /> Unit 4 <br /> 7. <br /> 8. ❑Unit 5 <br /> 10. [3 unit 8 <br /> Specific Date Range of Infomtatlon Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ® TH <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT WASE REE FACILCIYNEHICLE <br /> ®OTHER CLEANUP SITE(NON•LOP) E]FOOD FACILr Y Q <br /> ®UNDERGROUND TANK(MONITORINGIREMOVAL) L]DOG KENNEL DAIRY <br /> (�HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY Q MOTELIHOTEL Cr-]�PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> TATTOOMODY PIERCING ❑ LI <br /> POOLISPA LAND USE APPLICATION SffES <br /> [� MEDICAL WASTE FACILITY ©OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FwAY 8:00 AM-S:OOPM(EXCLUDING HOLIDAYS) <br /> 1. List up,tQ Wn add 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 0136 or_ afr it to the d�dr $ 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 W 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 EH°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 depoelt prior to review. <br /> EHD USE ONLY <br /> 4 ` <br /> SMD q8-0b <br />