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nIrc_zo_znnr Gq : lr YM JL-P—PRODUCTS 925 355 1514 P. 01 <br /> DATE RECEIVED.: ` • • EHb LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> �g ENVIRONMENTAL HEALTH DEPARTMENT <br /> 6 600 E.Mein Street,Stockton,CA 95202-3029 <br /> Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sjgov.o d <br /> -y <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT. P/4 �a[l�/7/+.J�/�E�1� bUSINMA=NCY: <br /> ADDRESS: / A ,K q en S-9+<' .�A�ru' C/' 94�� <br /> PHONE III: �.�� 6 and PHONE(21: 8a1 — �f_�k® � 3�3F FACSIMILE: <br /> TENTATIVE'APPOINTMENT DATE: Time; <br /> ,,,// (Please allow 10 business days from date of application submittal-•Tentodvo only-must be confirmed) <br /> CHECK BOX TO EXPEDITE REQUEST.x96.00 EE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 DU81NP88 DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List❑ Map—Description: <br /> FILE ADDRESS EHO USE ONLY <br /> N)/z 8treat 6 Dtrsat Name ......... Cay <br /> iiilgTz�' S Cl unfit <br /> 1. <br /> 2. Wt4 Ln UnIts <br /> 4. inkat, <br /> 6. Unit 4 1� <br /> 7. filla F,,:�A Unit a <br /> A. <br /> ❑ Unit 6 <br /> 10. <br /> Specific Date Range of Information Requested:From to <br /> �// ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> of fI NOEROROUND TANK(LIST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILMNEMCLE <br /> �TNER CLEANUP SITE(NON-LOP) 4 F000 PACILmTY ❑WASTE TRE <br /> �SINDERGROUND TANK(MOMTORINOMEMOVAL) In Doe KENNEL ❑DAIRY <br /> !P HAZARDOUS WASTE GENERATOR d CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> rl TIERED PERMITTED FACILITY ❑MOTELIHOTEL in PUMPER TRUCKIYARbICHEM TOILETS <br /> In TATToo/DOUYMERCINO C POOLISPA In(.ANO USE APPLICATION SITES <br /> in ME04CAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AYMIAeLE FOR REVIEW . MONDAY•FNDAY 6:00 AM-6:00PM - EXCLUOINO HOLIDAYS. <br /> 1. List up to ten addresses In the space above. Select the type(s)of flies from the list above by checking the appropriate <br /> box(es). At least one rile type MUST be selected. Fax to 120914840138 of mail t0 the address Indicated above. Address <br /> ranges will not be accepted—for additional assistance With file addressee,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 Slee 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 btlsin"Is 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 appllcatlon may be <br /> submitted when the file Is available. <br /> 4. Any file not returned In the same condlUon 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 196.00 deposit prior to review. <br /> EHD USE ONLY <br /> wcU <br />