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Jan-06-06 08: 10A Kraz-- and Assoc 559 ^118 2190 P.01 <br /> DATE RECEIVED tHU LUU NUMOCH <br /> SAN JOAQUIN COUNTY `w'' <br /> 011 C Ly ENVIRONMENTAL HEALTH DEPARTMENT /� I <br /> HJ L5 304 East Weber Averrue 3t°Floor, Stockton.CA 95202 2708 ITelephone:(209)468-3420 Fax: (209)464-0138 web: vvw.sjgov.org/shdPUBLIC RECORDS RELEASE APPLICATION2wi <br /> BUSn1E551A ENCY: f <br /> CC nCI� CITY ��1� STATE_�L�i �_I__�.r <br /> PNONEVI:,51W 3yPHONE( � FACSINILE,�59 .?lY 7J 'OLI%� <br /> TENTATIVE'APPOINTMENT DATE: �y✓—-��a Time: h2, 34� <br /> (Phase*lbw 10 Duafnell tlays h to of application aMal-'Te"UnivIl only-must be confirmed) <br /> CHECK BOX TO iXPEDITE REQUEST-1;93.60 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSaD IN 7 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> IMEhoetronic ❑ Ust 0 Map-DescrtP6on <br /> rmetlon <br /> I <br /> FILE ADDRESS EHO USE ONLY <br /> Street0 Stroll Name Gly <br /> I. 7Cj1f7 L/L"(I T10f /7 r ❑ Unit 1 <br /> a. Y ❑ nit 2 <br /> 4. T <br /> 5. nit 3 1\�� <br /> 6. nit 4 <br /> 7.e. ❑ Unit 5 <br /> 9. <br /> 110. 1 1 ❑ Unit 6 <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> ROROVNo TANK(ULT)CLEANUP SITE(LOP) ❑ HOUGOIG AMATEMeRT O sma WAST[FACX1 rvfmcm <br /> R CLEANUP SrfE(NDN.a.OP) ❑FOOD FACn1TY ❑WL9TE TIRE <br /> DERGROUND TALAR(MONnfNNNO/R£MOVAL) ❑DOG KERNEL ❑ DAIRY <br /> AZAROOull WASTE GENERATOR in CH(WIN RANCH ❑WASTEWATER Tt1EATMENT PLANT <br /> ❑Te?RED Pvetam ED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCRIy*";CHtMC1.l TOILETS <br /> C TArTOWBODY PIERCMG ❑POOL/SrA ❑LAND Use APP'✓CAIOH S"" <br /> ❑ MEDICAL W RETE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND 3EPIC PERMITRECOIIDS ARE AVAILABLE FOR REVMW-MONDAY-FAeAY 9;60 AM-6:00P4 - E*LUDWG HOLIDAYS. <br /> ,. List up to ten addresses In the space above. Select the type(s)of files from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax to(209)46L0,3B orto 1209)46L0,3B ormeil to the address <br /> j]�Enr 0lcated aboveabov . Address ranges will not be accepted-for additional assistance with file addresses, contact <br /> the EHD.Applications received after 3:00 pm will be processed the next business day. <br /> 2. The EHO will notify the applicant If any EHD flies exist, An appointment for review will be confirmed <br /> approximately ten (10)days after recelpt of application. The riles will be held for a maximum of five business <br /> days for review. Appointments 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 <br /> application 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 staf at the expense of the <br /> applicant. Future file reviews by the same applicant may require a$93.00 deposit print to review. <br /> Ella wee <br /> rult2xe <br />