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Fm:Ecology and Environment, Inc.-CSC Tr - n Joaquin Cty of Env Health Dept 14:28 0112811 OGMT-08 Pg 01-01 <br /> r.r <br /> r <br /> EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT ^ <br /> JAN `L S 2010 600 East Main St. Stockton, CA 95202-3029 (/JV' <br /> ENVIRONMENT HEALTTelephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/eh <br /> PE°AA1T L&10ES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: CrdigTL.4111 , BUSINESSIAGENCY: X094 41- <br /> ADDRESS: <br /> ADDRESS: /9yU bjP631L'a. Sik 100 CITY/STATE/ZIP: 60K 14d, CA 9011 <br /> PHONE(1): 510.6g3.67o0 er/-Y8// PHONE [2):, (5. Sola./ FACSIMILE: 610. 560 5740 _ <br /> TENTATIVE'APPOINTMENT DATE: a// In Time: //AWf <br /> (Please allow 10 business days from date of application submittal••Tentative only•must us confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$115 FEE(CASH OR CHECKONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ( Z4&.- DATE /bgbO <br /> Electronic Information: ❑List❑Map—Description: I <br /> FILE ADDRESS END USE ONLY <br /> Street# Street Name [3 unit <br /> 1. /5160 +la om,om 5 Pel` Vi Ij0 D <br /> u' 2. 160 ' of 1.4091-5! PUnjt2 <br /> 3• -Z <br /> 4. aid 3 <br /> 5. \6. nit 4 <br /> T. JT <br /> 8, ❑unll S <br /> 9. <br /> 10. nit s /y/ <br /> Specific Dale Range Of Informallmr Requested; From ',frunl.yiJa I $O to Tnm Tern '.1010 � I(,F�1 <br /> ENVIRONMENTAL HEALTH EPARTMENT FILES �,/ <br /> JfIDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT `lJSOUDWASTE FACILRYIVEHICLE <br /> gTHER CLEANUPSITE(NON-LOP) El Foci) M4 <br /> FACILITY ASTE TRE <br /> AI ' ��i'� <br /> IIDERGROUND TANK(MONITORINGIREMOVAI)� El DOG KENNEL El DAIRY [A <br /> ZARDOUS WASTE GENERATOR El RANCH ❑WASTEWATERTREATMENTPLRNT <br /> IERED PERMITTED FACILITY fx ❑MOTELMOTEL ❑PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> ❑TATID ODY PIERCING ,` ❑POOLISPA ❑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 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. Fax to(209)464.0138 or mail to the address Indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the END. 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(I D) <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 END staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$115 deposit prior to review. <br /> 5. if you need further assistance,please contact Diane Martinez,at(209)460.3425. <br /> EHDDSEONLY <br /> EHD 48.06 0121109 <br />