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Farrington .� <br /> Ql( tCEIVEL EI-10 LOG NUMBER <br /> / « SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> AFP V' 2 2008 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone; (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br /> *A <br /> = PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: li-oa Cheo ay BUSINESSIAGENCY: lcda AY4L� '✓�_ <br /> ADDRESS: 9Q2 Industrial Way cityrstatarzip Lads, CA 95240 <br /> PHONE(1): 2-09.367-370 PHONE(2): FACSIMILE: 2_-369-422$ <br /> TENTATIVE*APPOINTMENT DATE: 10-07-08 Time: gam <br /> (Ple;ase allow 10 business days from data of application submittal-*Tentative only-must be awiflrmed) <br /> lQ CHECK BOX TO EXPEDITF_Rrr=Q ST-5106 (CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE 9-23-08 <br /> Electronic Information: I] List[_j Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street* Street Nama City ❑ Unit 1 <br /> 1 25485 Highway 4 -__ Farmington ' Vo c,06'/' <br /> 2. Farmington f ��a lj Unit2 <br /> 4391 S Escalon Bellata Rd _ _ <br /> 3. if <br /> 4. Unit 3 <br /> 5, -- <br /> unit 4 <br /> a. I W <br /> D unit 6 <br /> 8. <br /> 91 ❑ Unit 8 <br /> 10. <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> XUmnFRGRoUNDTANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTR FACILITYIVEHICLE <br /> OTHER CLEANUP SITE(NON-1-OP) ❑FOOD FACILITY ❑WASTE TIRE <br /> X UNDERGROUND TANK(MONITORINGIREMOVAL)4- 0 DoG KFNN[L ❑DAIRY <br /> AzARDous WA3Tt:GENERATOR x, d CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILrrv' 0 140TF1_fH0TrI. ❑PUMPER TRUCK/YARDICIIEM TOILETS <br /> ❑TATTOO/BODY PIERCING �POOLISPA C1 LAND Us APPLICATION SITES <br /> ❑MrOICAL WASTE FACILITY OTHER(PLEASE SPECIFY)_ 'Q1u V'1 <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR Revrlcw - MONDAY-FRIDAY 8:00 AM-5:00Pm1 EXCLUDING HOLIDAYS. <br /> 1. List Lip to ten addresses In the space above. Select the type(s)of flies 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 aboYe, Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHO. Applications.received after <br /> 3:00 pm will be processed tho next business day. <br /> 2. The EHD will notify the applicant if any EH13 files exist. An appointment for review will be confirmed approximately ten(10) <br /> days after receipt of application. The files will he 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 FHD staff may not be Immediately available for review. A new application may be <br /> slubmItted when the filo Is available. <br /> 4. Any file not returned In the some condition as released will be reorganized by EHI)staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$106 deposit prior to review. <br /> EHD USE ONLY <br /> EHD d8-06 8I0E�O8 PUBLIC RECORDS RELEASE APP FORM <br />