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Apr 23 10 09:47a Krazan & Associates 559348190 P.1 <br />REEVED a <br />SAN aJOAQUIN COUNTY END LOG NUMBER <br />3 2010 ENVIRONMENTAL HEALTH DEPARTMENT <br />NT I1EAlTHT 600 East Main Street, Stockton. CA 95202-3029 <br />ENVIRUNK elephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />PERMITISERVICE3 <br />PUBLIC RECORDS RELEASE APPLICATION <br />13 <br />APPLICANT: .TO-rrL JZPbr)IWJ BUSINESS/AGENCY:LINA_ N} <br />ADDRESS: 2 1 S W . iii lc0TP, 6Wt City/State/Zip C:-02;.5 CA <br />PHONE(1): SSI- 0001! PHONE (2): FACSIMILE: .SC i, .-'4a->1 i0 <br />TENTATIVE` APPOINTMENT DATE: _PISA -F Time: <br />(Please allow 10 business days from date of application submittal - *Tentative only - must be confirmed) <br />13 CHECK BOX TO EXPEDITE REQUEST - $105 FEE ICASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT ��—��it� DATE 41 P3 (1f} <br />Electronic Information: <br />❑ List ❑ Map - Description: <br />15SOLID WASTE FAGLITYNEHICLE <br />AWASTE TIRE <br />4911, <br />' 1 � 1- <br />p UNDERGROUND TANK (MONITORINGIREMOVAL)a <br />0 DOG KENNEL <br />0 DAIRY <br />FILE ADDRESS <br />END USE ONLY <br />street # <br />Street Name city <br />Cl Unil1 <br />ep� <br />1. .. O - Oo <br />2. L <br />TZ'. <br />G <br />W.,/I (gi�Cl nN2 <br />3. <br />4.n <br />3 <br />S. <br />unit 4 <br />6. <br />7. <br />❑ Unit 5 <br />$ <br />9. <br />Unit 6 <br />10. <br />Specific Date Range of Information Requested: From PrL. _ to <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES <br />gi?41 <br />��H4,-NDERGROUND TANK (UST) CLEANUP SITE (LOP) <br />p -OTHER CLEANUP SnTE (NON -LOP) <br />0 HOUSING ABATEMENT <br />E3 FOOD FACILITY <br />15SOLID WASTE FAGLITYNEHICLE <br />AWASTE TIRE <br />4911, <br />' 1 � 1- <br />p UNDERGROUND TANK (MONITORINGIREMOVAL)a <br />0 DOG KENNEL <br />0 DAIRY <br />�}�t(� <br />W' <br />HAZARDOUS WASTE GENERATOR <br />TIERED PER F <br />0 CHICKEN RANCH <br />in <br />WASTEWATER TREATMENT PLANT <br />G <br />MITTED ACILITIO/, MOTELIHOTEL O PUMPER TRUCK/YARD/CHEMTOILETS <br />0 TATTOO/BODY PIERCING ❑ POOLISPA Cl LAND USE APPLICATION SITES <br />0 MEDICAL WASTE FACILITY ❑ OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW -MONDAY-FRIDAY 8;00 AM-5:OOPM - EXCLUDING HOLIDAYS <br />1. List up to 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) 464-0138 or mail to the address Indicated above Address <br />ranges will not be accepted — for additional assistance with file addresses, contact the END. Applications received after <br />3:00 pm will be processed the next business day. <br />2. The END will notify the applicant if any END files 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 on by END 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 END staff at the expense of the applicant. <br />Future file reviews by the same applicant may require a $105 deposit prior to review. <br />'J <br />