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�v SAN JOAQUIN COUNTY EHD LOG NUmsER <br /> EN VERONMENTAL HEALTH DEPARTMENT <br /> F '3 6 2005 304 East Weber Avenue, 3`d Floor, Stockton, CA 95202-2708 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/eh �n <br /> ENVIRONMENT HEALTH <br /> PF=2V,J11n"ERV'1r.ESPUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: RE_bP�ackeff _BUSINESSIAGENCY: Neil A Anderson and AssocinC, <br /> ADDRESS:PHONE(1): 2(19-867-3701 PHONE(21: FACSIMILE: <br /> TENTATIVE*APPOINTMENT DATE: Mar h Z 005 Time; <br /> (Please allow 10 business dmays frodata of applioaden submittal.'Tentative only-moat be Confi173 rmed) <br /> CHECK BOX TO EXPEDITE REQUEST-593.00 FEE CASH( `f <br /> OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUST IF-$ <br /> SIGNATURE OF APPLICANT DATE <br /> UNIT DISTRIBUTION 0UnNi ElUnit2 nk8 nits OUnItS 0 units ❑ Other(eteotonlwij:Wmaps) <br /> FILE ADDRESS � <br /> V2. <br /> Street Nam city EHD USE NLY <br /> L(yTck Tone RoO�, Lndi <br /> Specific Date Range of Infomlatlon Requested:From to <br /> ENVIRONMENTAL„HEALTH DEPARTMENT FILES <br /> ®UNDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 HOUSING ABATEMENT 0 SOLID WASTE FACIUTYNEHICLE <br /> M OTHER CLEANUP SITE(NON-LOP) ❑FOOD FACILITY 0 WASTE TIRE <br /> ®UNDERGROUND TANK(MONITORING/REMOVAL) O Doc KENNEL 13 DAIRY <br /> ®HATARDOUSWASTE GENERATOR OCXICKEN RANCH O WASTEWATER TREATMENT PLANT <br /> O TIERED PERMITTED FAOILTTY 0 MOTELIHOTEL O PUMPER TRUCKMAROICHEM TOILETS <br /> O MEDICALTATTOCIWASCOY E FACT G 0 POOIJSPA O LAND USE APPLICATION SITES <br /> Q MEDICAL WASTE FACIUN 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MONDAY-FRIDAY 6:00 AM-S;DOPM - Sl(CLUOING HOLIDAYS. <br /> 1. List up to ten addresses in the space above. Select the types)Of files from the list above by checking the <br /> appropriate box(es). At least one file type MUST be selected. Fax to(209)464-0138 or mail to the address <br /> indicated above. 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 EHD will notify the applicant if any EHD Tiles exist. An appointment for review will be confirmed <br /> approximately ten(10)days after receipt of application. The files 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 staff at the expense of the <br /> applicant Future file reviews by the same applicant may require a$93.00 deposit prior to review. <br /> EHO AE-02ao6 <br /> 1/t11DF <br /> 0/Z0 39vi OHIAN3 NOSJGGNV 1I3N BZZV69E60Z ZZ:91 T00Z/9i/Z0 <br />