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@9T/�17/2008 16:07 9165642222 KRAZAN PAGE 02/02 <br /> G�@ATEi20I1 �.✓ EHU LOU NUMBER <br /> I SANJOAQUIN COUNT' <br /> ENVIRONMENTAL 1IEAI,,T" DI,,PARTMENT <br /> SEP g a 2008 600 East Main Street, Stock-ton, CA 95202-2708 <br /> Fa{'11R0+ii'+'•- i tiii.r3+ Telephone; (209)468-3420 Pax: (209)464-0133 Web: tvww.sjgov.org/ehd <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: /�vv/���yLL B/USINESSIAGENCY;p. <br /> ADDRESS: S�TI/'T 1 �LR�/ _�'CnI�J� . ///C 4.4.Cv�/ C� /J[o✓ p� // ,,may <br /> PHONE(t). 7�Q� J� ��'� PHONE 2): F�� .�Co'� .�o CJ FACSIMILE': /1w J7� Z' <br /> TENTATIVE*APPOINTMENT DATE! Time: <br /> (Please allow 10 business days from date of application submittal-`Tenfatfve only-must be confirmed) <br /> XCHECK BOX TO EXPEDITE REQUEST-$98 E(CASH OR CHtiCK ONLY)-REQUEST PROCESSED IN 3 SUYNES5,DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street N Street Name city ❑ Unit t <br /> ❑ unit 2 <br /> 3 a E 1 Z JAI <br /> 5. <br /> .-.- - unit 4 <br /> 6. <br /> 7• ❑ Unit 5 <br /> B. <br /> 9. Unit 6 <br /> Specific Date Range of Information Requested: From to <br /> 4 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES a t„ <br /> RV.t1ONDERGROUND TANK(UST)CLEANUP Sim(LOP) C]HOUSING ABATEMENT OLID WASTE FACILITY1WHICLE <br /> iHER CLEANUP SITE(NON-LOP) El FOOD FACILITY ASTE TIRE 7 <br /> UNDERGROUND TANK(MONITORINGIREMOVAL)D_ O DOG KENNEL ❑ DAIRY 7 <br /> AZARDOUS WASTE GENERATORY- 0CHICKEN RANCH O WASTEWATER TREATMENT PLANT Un If _3 1� <br /> 3iETIEREO PERMITTED FACILITrp'. 0 MOTEL/HOTEL 0 PUMPER TRUCKlYARDICHEN;TOILETS waltv <br /> 0 TATTOO/BODY PIERCING 0 POOL/SPA 0 LAND USE APPLICATION SITES <br /> 0 MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW -MONDAY-FRIDAY 8:00 AM4:00PM - ExCLUDING HOLIDAYS. <br /> 1. List up 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(x09)464-0138 or mall to the address indicated above. Address <br /> ranges will not be accepted-for additional assistance with file addresses,contact the EHD.Applications received after <br /> 3:00 pm will be processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD filas exist. 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 /> 3_ A file that is actively being worked an 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 EIiD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> If you should need further assistance please contact Diane Martinez @ (209)468-3425 directly. Thank You*** <br /> -41 24vy 10 Q (kt d L <br /> se <br /> EHO 4"6 TIA4 $ <br />