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06/03/2008 09:51 FAX 5302431851 C112 HILL 2002/002 <br /> _ EHD LOG NUMBER <br /> DATE RECEIVED 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 www.sjgov.D <br /> Web: /e <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: 1. A (q j5 BUSINESSIAGENCY: CNJ-tl ldl lI <br /> ADDRESS: �.SZS •! r I^ C' �;r t.,t� 11-C%r, <br /> PHONE(1): .`-3'�'T.'7.S'j•-3PHONE(2): FACSIMILE: �.3."�39-32y�� <br /> TENTATIVE"APPOINTMENT DATE: 6I17ivg Time:fav <br /> (Please allow tan business days fmm date of application submittal-•TentadvD only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQUEST-$98.00 FE (C H OR CHECK ONLY)-REQUEST PROCESSED IN THREE BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 62108 <br /> Electronic Information: ❑List❑Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street• Street Name City EUnh1 <br /> El oomlo ` octthan d US 6$ III <br /> �1 J 343-4 5 rDo04 fit tt (7�: kw O)'IY> > t2 <br /> 3244� 1 /101 o IU- <br /> 3�o Ape Atpy ` L) tr AS II I <br /> 31 � $- E1 Docatlo L4 —2 <br /> z s a; t oA S- 57 :1: N�a(Dn iii 6- IJNIt4 <br /> ��"\� 3105 lAmrado ` $ 6 L)To <br /> es 1k� <br /> 3032 TL 40 ��� �' �LJ 106$ of units <br /> - aaaa Re;n� s4 IIm cry It Au z) ; , � <br /> ►'W Rto �J C- nit$ <br /> 8a( �w( ti Av-t S <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES all/ <br /> 4NOERGROIIND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT 14OUDWASTEFACILIY/vEHIC E Q V <br /> (D,THERCLEANUP SIM(MON-LOP) ❑FOOD FACILITY 91'WASTE711% <br /> NDERGROUND TANK(MONITORINGIREMOVAL) 13 DOG KENNEL ODAIRY �� <br /> US WAS TE CaENERATOR OCHO <br /> CHICKEN RANCH WASTEWATER TREATMENT PLA ✓ <br /> I+I TIEREO PERMITTED FACILITY ❑MOTEUHOTEL ?/PUMPER TRUCK/YARDICNEM TOI <br /> TATTOOIBODY PIERCING ❑fPMIJSPA '(1 LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY MOTNER(PLEASESPECIFY) 010$ "q71 <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW-MONDAY-FRIDAY 8:00 AM-$:OOPM-ExcLuaNG HOLIDAYS. <br /> 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fa:to 42091464-0130 or mail to the above address. Address ranges will <br /> not be accepted-for additional assistance with file addresses,contact the EHD, Applications received after 3:00 pm will <br /> 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 <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 the EHD 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 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 /> OY7 D ) ,(t ti . (),} t iet G I TV <br /> ENDu�IWMI PUBLIC RECORDS RELEASE APP FORM <br />