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08/09/2007 THU 15;04 FAX 2082999 SJC PUBLIC WORKS � X001/006 DATE RECEIVED EHD LOG NUMBER SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 304 E Weber Ave 3`d Floor Stockton, CA. 952031,1192 (M9) 468-3420 Fax: (209) 464-0138 Web: www.co.sanjoaquii PUBLIC RECORDS RELEASE APPLICATION APPLICANT: Claudia Gemberl.ing BUSINESS/AGENCY: San Joaquin County Public Works Department ADDRESS: 1810 E. Hazelton Avenue, Stockton, California 95205 PHONE: 953-7624 FACSIMILE: 468-2999 TENTATIVE* APPOINTMENT DATE: Tlmo: (Please allow 10 business days from data of application submittal) r CHECK BOX TO EXPEDITE REQUEST - $93.00 FEE — REQUEST PROCESSED IN 3 BUSINESS DAYS Q SIGNATURE OF APPLICANT dj" f �, Gj2 � DATE Department Use Only C r6 a�- ENVIRONMENTAL HEALTH DEPARTMENT FILES Unit 2 Unit 3 Unit 4 © Unit 5 (0 UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT � SOLID WASTE FACILITY V" OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY SOLID WASTE VEHICLE �C UNDERGROUND TANK (MONITORING/PEMOVAL) ❑ DOG KENNEL DAIRY HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH PKG TREATMENT PLANT TIERED PERMITTED FACILITY ❑ MOTELIHOTEL O PUMPER TRUCKIYARDlCHEM TOILETS TATTOOlBODY PIERCING 0 POOL15PA 17 LAND USE APPLICATION SITES ❑ MEDICAL WASTE FACILITY Q OTHER (PLEASE SPECIFY) 1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checking ; the appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0138 or mail to the address indicated above. 2. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately five business days but no later than ten (10) days after receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. 3. A file that is actively being worked on by END staff may not be immediately available for review. A new application may be submitted when the file is available. Any file not returned in the some condition as released will be reorganized by EHD staff at the expense of the applicant. Future file reviews by the same applicant may require a $93.00 deposit prior to review. *MNTATIVV. appointment dates must be confirmed with EHD staff. - ons received after 3:00 p will be processede next business day. ICQNF�F1�fEf`D' AP.IElGS1ITMt*r�IT UAT�11id: DATE'COK RRNIED' PHS) E FSC. _ li�SIfYAL f; E1if no :tlid erw 4M2-006 VWMW FILE ADDRESS I. stmt OSAl)&{D4 W - Sf, ON z. svent % i a -,11a 9. Strad OGU too '— a. swar P-0 G r% _ ftA 51P city yl o 11 IQay e. street D Q 7. sit _ . b rity vin� to sweet a 3D G -� ENVIRONMENTAL HEALTH DEPARTMENT FILES Unit 2 Unit 3 Unit 4 © Unit 5 (0 UNDERGROUND TANK (UST) CLEANUP SITE (LOP) ❑ HOUSING ABATEMENT � SOLID WASTE FACILITY V" OTHER CLEANUP SITE (NON -LOP) ❑ FOOD FACILITY SOLID WASTE VEHICLE �C UNDERGROUND TANK (MONITORING/PEMOVAL) ❑ DOG KENNEL DAIRY HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH PKG TREATMENT PLANT TIERED PERMITTED FACILITY ❑ MOTELIHOTEL O PUMPER TRUCKIYARDlCHEM TOILETS TATTOOlBODY PIERCING 0 POOL15PA 17 LAND USE APPLICATION SITES ❑ MEDICAL WASTE FACILITY Q OTHER (PLEASE SPECIFY) 1. List up to ten addresses in the space above. Select the type(s) of files from the list above by checking ; the appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0138 or mail to the address indicated above. 2. EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately five business days but no later than ten (10) days after receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. 3. A file that is actively being worked on by END staff may not be immediately available for review. A new application may be submitted when the file is available. Any file not returned in the some condition as released will be reorganized by EHD staff at the expense of the applicant. Future file reviews by the same applicant may require a $93.00 deposit prior to review. *MNTATIVV. appointment dates must be confirmed with EHD staff. - ons received after 3:00 p will be processede next business day. ICQNF�F1�fEf`D' AP.IElGS1ITMt*r�IT UAT�11id: DATE'COK RRNIED' PHS) E FSC. _ li�SIfYAL f; E1if no :tlid erw 4M2-006 VWMW