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DAT A� O 1J E© • SAN JOAQUIN COUNTY • END LOG NUMBER int I�iLL�� NOV 2 0 2006 ENVIRONMENTAL HEALTFI DEPARTMI+rNT 304 Last Weber Avenue, 3`1 Floor, Stockton, CA 95202-2708 ENVIRONMENT HEALTIfepbome: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd 4 PERMfTfSA�N/E"CESS PUBLIC RECORDS RELEASE APPLICATION APPLICANT: /'gam ! ^ BU51NE55lAGENCY: T v PHONE('): �1S" :l- Y PHONE(2): ��5�',,�-`!)-57fS4 FAC51MILt: TENTATIVE" APPOINTMENT DATE: , �� d'F(=� - Time: joi (Please allow 10 business days from date o>�Ileadon submittal - • I en'adve only - must be I.7 CHECK BOX TO EXPEDITE REQUEST -§95.0000 FEE (CASH OR CHECK ONLY) - REQUEST PROCESSED IN 3 BUSINESS DAYS SIGNATURE OF APPLICANT kA If j� !t17 �" DATE/46K/0- 1 4 L/ Electronle Information: ❑ List ❑ Map - Description: Street IY FILE ADDRESS Street Namen EHD USE ONLY City ❑ Unit 1 Lpx uS LA r 14 ❑ unk2 . Unit 3 D Unit 4 ❑ Unit 6 - ❑ Unit s 1 2. 142 &JAL kplldnT $. ,7 51 4. $1 i4eflmr Aa - 5. 7. e. 8. 1 D. A NO SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY -FRIDAY iI;OO M-5:OOPM - EXCLUDING HOLIDAYS. s of files from the list above by checking the appropriate 1. List up to ten addresses in the space above. Select the type(s) box(es). At least one file type MUST be selected. Fax te 209 454.0198 or mail to the add ss Applications nsbrecelved afters ranges will not be accepted -for additional assistance with file addresses, contact the END. App 3;00 pm will be processed the next business day, approximately ten 10 2. The END will notify the applicant if any EHL) files exist. An appointment for review will be confirmed app Y ( 1 days after receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. application may be 9. A file that Is actively being worked on by END staff may not be immediately available for review. A new app' submitted when the file is available. 4. Any file not returned in the same rendition may require re a ill a reorganized degas t priorto NDrevstaff at the expense of the applicant. Future rile reviews by the same app rJM I ICC !11.11 V Specific Date Range of Information Requested: From to ENVIRONMENTAL HEALTH DEPARTMENT FILES r�/ANK O HOUSING AaATEMEN7 0 SOLID WASTE FACILITYNEHICLE ,03)TDER CLEANUP SITE UST -CLEANUP SITE O FOOD FACILITY CI WASTE TIRE �,�r^OTHERCLEAND TANK (NON -LOP) ❑ DOC KENNEL 0 DAIRY y/C� UNDERGROUND TANK GENERATOR p CHICKEN RANCH 0 WASTEWATER TREAn1ENY PLANT WK Tp7ARDOU6 WASTE CrENERATOR 17 MOTEIJHOTEL 13 PUMPER TRUCKIYARDICHEM TOILETS IERED PERMITTEb FACILITY ❑ POOLISPA t7 LAND USE APP LI,ICATION SITES • TATTOOIBODY PIERCING THER (PLEASE SPECIFY) WL QeCYE(s •MEDICALWASTEFACILITY V "ELL S0 39t1d Hd 9NIb33NION3 0113 06L76ULJ56b1 60 .6 1 71U6/W6/LL 13 s of files from the list above by checking the appropriate 1. List up to ten addresses in the space above. Select the type(s) box(es). At least one file type MUST be selected. Fax te 209 454.0198 or mail to the add ss Applications nsbrecelved afters ranges will not be accepted -for additional assistance with file addresses, contact the END. App 3;00 pm will be processed the next business day, approximately ten 10 2. The END will notify the applicant if any EHL) files exist. An appointment for review will be confirmed app Y ( 1 days after receipt of application. The files will be held for a maximum of five business days for review. Appointments should be scheduled accordingly. application may be 9. A file that Is actively being worked on by END staff may not be immediately available for review. A new app' submitted when the file is available. 4. Any file not returned in the same rendition may require re a ill a reorganized degas t priorto NDrevstaff at the expense of the applicant. Future rile reviews by the same app rJM I ICC !11.11 V Specific Date Range of Information Requested: From to ENVIRONMENTAL HEALTH DEPARTMENT FILES r�/ANK O HOUSING AaATEMEN7 0 SOLID WASTE FACILITYNEHICLE ,03)TDER CLEANUP SITE UST -CLEANUP SITE O FOOD FACILITY CI WASTE TIRE �,�r^OTHERCLEAND TANK (NON -LOP) ❑ DOC KENNEL 0 DAIRY y/C� UNDERGROUND TANK GENERATOR p CHICKEN RANCH 0 WASTEWATER TREAn1ENY PLANT WK Tp7ARDOU6 WASTE CrENERATOR 17 MOTEIJHOTEL 13 PUMPER TRUCKIYARDICHEM TOILETS IERED PERMITTEb FACILITY ❑ POOLISPA t7 LAND USE APP LI,ICATION SITES • TATTOOIBODY PIERCING THER (PLEASE SPECIFY) WL QeCYE(s •MEDICALWASTEFACILITY V "ELL S0 39t1d Hd 9NIb33NION3 0113 06L76ULJ56b1 60 .6 1 71U6/W6/LL 13