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DATE RECEIVED SAN JoAQuIN CO 'Ww EHD LOO NUMBER <br /> COUNTY <br /> EC;Fl\/E® ENVIRONMENTAL STEALTH DEPARTMENT 5 "% `3 Q L — <br /> v 600 E.Main Street,Stockton, CA 95202-3029 U c� i <br /> 29 201Q Telephone: (209)468-3420 Paz:(209)464-0138 Web:wfvw.sjgov.org/ehd <br /> DEC <br /> PUBLIC RECORDS RELEASE APPLICA'T'ION <br /> AI p� NTvw"7T BUSINESSIAGENCY: Live Oak GeoEnvironmental <br /> na <br /> ADORA-R . Oak St.,Lodi, CA 95240 <br /> PHONE(1); (209)369-03T5 PHONE(2): FACSIMILE: (209) 369-0377 <br /> TENTATIVE'APPOINTMENT DATE: ✓ RI Z0t0 Tim: 9:00 am <br /> (Please Allow 10 business days from date of ap alien submittal-*TasraWe only-must be confirmed" <br /> 13 CHECK BOX TO EXPEOITE REQUE�ST'-�$95.00 FE�E'MCASH OR CHECK ONLY)-REQUEST PROCESSED IN 9 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT dL /G DATE 17-1.7-1/(O <br /> Electronic Information: ©List® Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street R Strad Name CRy ^, ❑ unit 1 <br /> 1. t1o90 � . C3..ka� teal. S+Da- <br /> 2. 117-111& , . 3a1-Al Qat. 5-�'U�-�'- Gl Nw UnR2 <br /> 3. <br /> 4. U—.It 3— <br /> �. <br /> Unit 4 <br /> T' ❑ unit s <br /> 8. <br /> g' ❑ Unit 0 <br /> 10. <br /> Specific Date Range of information Requested: From all available to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES P TM <br /> � NDERGROUND TANK(UST)CLEANUP SITE(LOP) C HOUSING ARATEMIENT 0SOU0WASTEFACILITYNEHICLEtw t <br /> CN <br /> R)QTKCLGINVP SITE(WON-LOP) OFOOD FACILITY IJ WASTE TIRE W•, <br /> 951NDEROROUND TANK(MONITORIN NOVAL)#* 0DOE KENNEL0DAIRY '. ��'� <br /> SHAZARDOUS WASTE GENERATOR GCHICKEN RANCH O WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY I 0 MOTGJHOTEL ©PUMPER T2UCKIYARDICHEN TOILETS <br /> 0TATTOOIBODYPIERCING UPOOLISPA I7LAND USE APPLICATION SITE$ <br /> Cl MEOICAL WASTE FACILITY M OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORD$ARE AVAILABLE FGR REVIEW- MONOAY-FRIDAY 8:00 AM-S:OOPM - EXCLUDING HOLIDAYS. <br /> 1. List up t0 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)4A-9198 Or mail to Uie add a indigi tel above. Address <br /> ranges will not be accepted-for additional assistancewith file addresses,Contact the EHD.Applications recalved after <br /> 3:00 pm vdll be processed the next business day. - <br /> 2. The EHD Will notify the applicant if any EHD files exlsL An appointment for review will be confirmed approximately ten(10) <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 /> a. A file that is acfively 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 EHD staff at the expense of the applicant <br /> Future file reviews by the same applicant may require a$95.00 deposit prior to review. <br /> EHD USE ONLY <br /> ENDO M SM12M .b <br />