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01/11/2011 18:40 AEI CONSULTANT" PAGE 01/01 <br /> RE ""'EIVE® EHD LOG NUMBER <br /> SAN JOACOUNTY 59193 <br /> JAN 1 1 2011 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St, Stockton, CA 95202-3029 <br /> ENVIRONMENTAL HEATMPhone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT; BUSiNESSIAGENCY: AE y&Aga <br /> ADDRESS: pD rkmiUp Play CITWSTATEIZIP:_y,iM.})U( _ <br /> PHONE(1): PHONE(2) 11 FACSIMILE:�� r( O�cj <br /> TENTATIVE'APPOINTMENT DATE: ( � � Time: <br /> (Please allow 10 noalnesa days from tlate of application Submittal-•TanorfAro dln <br /> only-mutt be cotnad) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$115 FE (CAM HECK ONLY)•REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE I III I LdU <br /> Electronic Information: ❑List❑Map—Description: <br /> _ FILE ADDRESS EMD USE ONLY <br /> street If Street Name city <br /> -- - -. _. ❑Unit 1-. <br /> fi IIVo 1 <br /> irlV� 2. 40 <br /> 3. s7"I�_ _ Unit2 1121 <br /> .�r _.�._ Sf . I <br /> 4. <br /> nit 3 <br /> 7. - .... nit4 <br /> 9. O.UnitS <br /> unit e <br /> 9pacdic nate Range of Irrfomx+tlon Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES � �j <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT UD WASTE FACILITYNEHICLE <br /> tuo <br /> THER CLEANUP SITE(NON-LOP) �,/.. ❑FOOD FACILITY WASTE TIRE LM,.. <br /> DERGROUND TANK(MONITORmGIREMOVALK" ❑DOG KENNEL ❑DAIRY Lt,�1I <br /> Z WASTE GENERATOt� ©CHICKEN RANCH �.yJ��'�ASTEINATER TREATMENT PLANT <br /> IERED PERMITTED FACILITY Q` ❑MOTEL/HOTEL L sJ PUMPER TRUCKIYARDICHEMICAL TOILETSI JI <br /> TATTOOIBODY PIERCING ❑POOUSPA ❑LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00pm(EXCLUDING HOLIDAYS) <br /> 1. List ub to ten addressee In the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one Nle type MUST be selected. ERX to(2091484.0138 or me If 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 END will nOtify the applicant if any END files exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The files will behold 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 END 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 END staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$115 deposit priorto review. <br /> 5. if you need further assistance,please contact Diane Martinez,at(209)45S-3425. <br /> • <br /> ND11M ONLY <br /> - oil <br /> CHI)N� <br /> NTlN9 <br />