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May 15 08 12:25p Paul Humphre� jj 226-3408 p.1 <br /> EHD LOG NUMBER <br /> '1L 7E" ff ED SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Qy "' `� <br /> MAY 1 7 2008 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sjg v.o <br /> ENVIRONMENT HEALTH <br /> PFRMIT!SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT, /, BUSINESSIAGE,fNCY: <br /> ADDRESS: 7V Z i'4�o<t + v& <br /> PHONE(p: 52� 977-21 �—PHONE(2): FACSIMILE: �7S `J Z .�y01t <br /> TENTATIVE'APPOINTMENT DATE: Time: <br /> (Please allow ten business days from date of application submittal-'Tentative only-must be confirmed) <br /> £CK BOX TO EXPEDITE REQUEST-$98.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN THREE BUSINESS DA <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑List Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City ❑ Unit 1 <br /> 7 %vw7 d Dr. _ VO Il o. <br /> 2. 5 �J 1'2i�? ;7�i ✓/- D t41�1,Dfs�/.va50,V 0 comek z <br /> 3. 2735 ez t7r. � c tte�r� uhT 5 \� <br /> - C It / ( /oCs/,vDSPIuo u11 . <br /> 4- <br /> fey G: D!: <br /> �nil4 <br /> 6. <br /> 7. <br /> O units <br /> S. <br /> g nil 6 <br /> Specific Date Range of Information Requested:From to / 0 � <br /> ENVIRONMENTAL PA TME S <br /> 15:UNDERGROUND TANK(UST)CLEANUP SITE(LOPI 0HOUSINGBATEMENIT LID WASTE FACILRYrVEHICLE <br /> P�*THER CLEANUP Sim(Nom-LOP) 13FOOD FACILITY WASTETIRE <br /> g:UNDERGROUND TANK(MONITORINGIREMOVALI ❑DOG KENNEL ❑DAIRY Q1' <br /> 5HAZARDOUS WASTEGEHERATDR L3 CHICKEN RANCH 'Z WASTEWATER TREATMENT PLANT <br /> ,19-TIERED PERMITTED FACILNY 13MOTEUHOTEL ElPUMPER TRUCKIYARDICHEM TOILETS <br /> TATTOOIBODY PIERCING 0 POOLISPA ❑LAND USE APPLICATION SITES <br /> 171 MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR RE`AEW- MONDAY-FRIDAY 8:00 AM-5:00PM -EXCLUDING HOLIDAYS. <br /> 1. List up to ten addresses in the space above. Select the types)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 above address. Address ranges will <br /> not be accepted-for additional assistance with file addresses,contact the EHD. Applications received after 3:00 pm will <br /> be processed the next business day. <br /> 2. The EHD will notify the applicant it any EHD files exist An appointment for review will be confirmed approximately ten <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 the EHD staff may not be immediately available for review. A new application <br /> may be 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 S98.DO deposit prior to review. <br /> EHD USE ONLY <br /> . 3t,33 Grulc <br /> PUBLIC RECORDS RELEASE APP FORM <br /> EHD48A6 101251e7 <br />