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08/21/20009 FRI 9: 50 FAX 209 858 6404 J R Simplot Engineering 0001/001 pA rig EHD LOG NUMBER LL=�jw '`1�7��llr�_ SAN .)OAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT AUG b 1 2009 600 East Main St. Stockton, CA 95202-2708 '/V/ /� Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd 0 pr-r! lrgi-� j HEAD PUBLIC RECORDS RELEASE APPLICATION APPLICANT: 21,A, MOCL _ BUSINESSIAGENCY: __5 C< S;r✓{�j� f (J ADDRESS: 16777 /-h;,, a, tt tZd.. CITY/STATEIZIP: I( /�.,;/» , CA PHONE(1): 704- b'S 6 L/Z PHONE(2): 7a9- /,tll- %3r//% FACSIMILE:J�4- TENTATIVE"APPOINTMENT DATE: MI09 Time: q."56 AM (Please allow 10 business days fromd te�ation submittal-`Tentative only-must be confirmed) ❑CHECK BOX TO EXPEOITE REQUEST-$115.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS SIGNATURE OF APPLICANT DATE Electronic Information: ❑List❑ Map-Description: _ FILE ADDRESS EHD USE ONLY Street R Street Name Ciry ❑ nit 1 2. Unit 2 4. � r� 6. _. _. ---- .-. __..._ _..... _ nit4 ___.. 7. 8. ---_--- - ----------.___ ------- ------__---- ---------._--___._---------'--- Unit 5- 9. 10. (]Unit 6 Specific Date Range of Information Requested: From /�/ifi�SS� to /2 i - . (1 „ ENVIRONMENTAL HEALTH DEPARTMENT FILES O UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT ❑SOLID WASTE FACILITYNEHICLE V OTHER CLEANUP SITE(PION-LOP) ❑FOOD FACILITY ❑WASTE TIRE UNDERGROUND TANK(MONITORINGIREMOVAL) El DOG KENNEL [I DAIRY HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT D ❑TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKWARD/CHEMICAL TOILETS ❑TATTOOIBODY PIERCING �❑(POOL/SPA ❑LAND USE APPLICATION SITES [-I ,lam MEDICALWASTE FACILITY OTHER(PLEASE SPECIFY) 4,y fit/ pul4,- ed WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) 1. List up to ten addresses in the space above. Select the type(s)of files from the list above by checking the appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address Indicated above. Address rangevvvill not be accepted for additional assistance with file addresses,contact the EHD. Applications received after 3:00 pm will be processed the next business day. 2. The EHD will notify the applicant if any EHD hies exist. An appointment for review will be confined approximately ten(10) days after receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. 3. A Nle that is actively being worked on by EHD staff may not be immediately available for review. A new application may be submitted when the file is available. 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant Future file reviews by the same applicant may require a$115.00 deposit prior to review. EHD USE ONLY *'*If you need further assistance please contact Diane Martinez @ (209)468-3425 directly. Thank You""* sYa �. .