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Apr,23, 2008 11:03AM <br />DATE rcttivmv <br />D` <br />APR '� `3 2008 <br />HEALTH <br />'" - •^ed G e o I n v i r o n m e n t a 1 <br />No' 1830EHDP' 1VUMBER <br />. v SAN JOAQUIN COUNTY � <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/chd <br />PUBLIC RECORDS RELEASE APPLICATION <br />PHONE (1): 74p J _ la i� PHONE (2): 6:'01 - `f06 % FACSIMILE: <br />TENTATIVE` APPOINTMENT DATE: Time: <br />(Please allow 10 business days from date of application submittal-•Tentathre only - must be confirmed) <br />HECK BOX TO EXPEDITE REQU $98.00 FEE§( SH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAY <br />SIGNATURE OF APPLICANT ( =� 'rte DATE - Z3 -0 <br />Electronic Information: ❑ List ❑ Map - Description: <br />❑ HOUSING ABATEMENT <br />FILE ADDRESS <br />EHD USE ONLY <br />"NDERGROUND TANK (MONITORINWREMOVAL) <br />street # <br />Street Name <br />CI CHICKEN RANCH <br />4 � � Unit 1 <br />I d d 5 - <br />❑ MOTEUHOTEL <br />pleas <br />E�6'r 1���e- <br />_ <br />,tern <br />❑ OTHER (PLEASE SPEC <br />,2055 <br />6,A7 57- GV6&,C:�iKI <br />... <br />' -- <br />� c! —vw 5C- ❑ Uli <br />�tIlan, ru <br />02)(0 1) 10 (�YIU5 <br />X0 75" <br />Ls7sr GJ� a'.�L <br />,�,tw' <br />33"744 I+qo ccuf <br />SF/U" <br />a7�;o a nk4 <br />s.$f�02) <br />7. <br />❑ units <br />8. <br />__.._ <br />9. <br />Unite <br />10. <br />_ <br />Specific Date Range of Information Requested: From <br />7.1 <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />96NDERGROUNO TANK (UST) CLEANUP SITE (LOP) <br />❑ HOUSING ABATEMENT <br />El OTHER CLEANUPSITE(NOWLOP) <br />171 FOOD FACILITY <br />"NDERGROUND TANK (MONITORINWREMOVAL) <br />11 DOG KENNEL <br />41RIAZARDOU8 WASTE GENERATOR <br />CI CHICKEN RANCH <br />❑ TIERED PERMITTED FACILITY <br />❑ MOTEUHOTEL <br />171 TATTOO/BODY PIERCING <br />0 POOUSPA <br />❑ MEDICAL WASTE FACILITY <br />❑ OTHER (PLEASE SPEC <br />All-". <br />OLID WASTE FACILITYNEHICLE �,��k �7• <br />❑ WASTE TIRE �� <br />13 DAIRY SNY <br />❑ WASTEWATER TREATMENT PLANT <br />• PUMPER TRUCK/YARD/CHEM TOILETS <br />13 LAND USE APPLICATION SITE$ <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY -FRIDAY 8:00 AM-B:GOPM - FxOLUDINa HOLIDAYS. <br />1. List up to ten addresses in the space above. Select the type(s) of Ries from the list above by checking the appropriate <br />box(es). At least one flee type MUST be selected. Fax to (2091464.0136 or mall 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 EHD will notify the applicant if any EHD files 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 business 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 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 $98.00 deposit prior to review. <br />EHD USE ONLY <br />A< <br />