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APR 16,2008 12:22 000-000-00000 ..r page 1 <br />[EbATIEWEIViEbL, V EHO LOG NUMBER <br />- SAN JOAQUIN COUNTY <br />APH 1 0 (110T ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202-302)39 5k(l <br />EN4IP.1,1 d e1 -,! L ,"Telephone: (209) 468-3420 Fax: (209) 464.0138 Web: wwws/e <br />PUBLIC RECORDS RELEASE APPLICATION <br />APPLICANT' r 7 / BUSINESS/AGENCY r(I VAI iI n�l/I�.Lr,S <br />AnORESS: 3 - q <br />PHONE (t ):9��•.�.jg PHONE (2)! ��� % � �i •y7^ri FACSIMILE: �1 ',,, <br />TENTATIVE" APPOINTMENT DATE: / / 1 CLV . Ti,.- /O ; FN't'' <br />(Pleas ASOw len bualnaaa dove from data of prim Ont Submittal - • Tentative only - must be confined) <br />CNECK BOX TO EXPFDnE REQUE$ F (CASH OR CHECK ONLY)- REQUEST PROCESSED IN THREE BUS1 $S DAYS <br />SIGNATURE OF APPLICANT DATE <br />EleCtronlc Information: ❑ Llst ❑ Map- Descrlptlon: <br />Sheat 0 Strael Nama City <br />17) <br />a4; <br />93_0 wI a?i 6+ vyL fl0 0Unit 2 /I , <br />nn'' �� • �-�. �.�t� l o 'o oZ <br />(A 0 V S kv t j ❑ unit 8 <br />I(�15L. LYn i N <br /><Stoc�ctor, � $ <br />oz, - <br />Specific Date Range of Information Requested; From ,. <br />���...,,,,,,,,,(((((( ENVIRONMENTAL HEALTH DEPARTMENT FILES V ej /dJ✓,.•n <br />4UMDER(CLEANUTANK (UST) CLEANUP SITE (LOP) ❑ FODSINO ABATEMENT L$OLID WASTE FACILITYMEHICLE l/r , N <br />OTHER CLEANUP SITE (NON{OP) P FOOD FACILITY �W WASTE TIRE U I ) <br />UNOERDROOW TANWASTE <br />Ge ERATO Nd/REMOYPL)Qt Q DOG KENNEL C3 DAIRY I I /�Jy149 , <br />AREO OQS PEIATTEDOILITY4. I 13 CHICKEN RANCH 13 WASTEWATER TREATMENT PLANT 'i G <br />1�5TAMOMERMITTE RCINS itta. 0 MOTELINOTEL ❑ PUMPER TRUCKNARD/CHEM TOILETS <br />E3 MEDICAL WAS PIEACIIU 0 POOIISPA Q LAND USE APPUCA71ON SITES <br />MEDICAL WASTE FACILITY 0 OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PMMI7 RECORDS ARE AVAa-AaLE FOR RENEW . MONDAY -FRIDAY 8:00 AM.$;OOPM . E%CWgNG HOUDAYS. <br />1. List Up to ten addresses in the space above. Select the type(9) of Nies from the list above by checking the appropriate <br />box(es). At least one file type MUST be selected. Fax le 121191 4 8 4-0138 or mall to the above gddrg. Address ranges will <br />not be accepted - for additional assistance With file addresses, contact the END. Applications received after 3:90 pm Will <br />be processed the next business day. <br />2. The END will notify the applicant If 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. Appointment$ <br />should be scheduled accordingly. <br />3. A file that Is actively being worked on by the END 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 END 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 />END USE ONLY <br />