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DATE RECEIVED C w Qr� LI-ID LOG NUMBER <br /> SAN �w,7AG�UoiV dl�l�Tlf <br /> ENV[RONRBEIN TAL. HEALTH DEPARTMENT <br /> 600 Cast Dain Street, Stockton, CA 95202-3029 <br /> Telephone. (209)458-3420 Fix: (209)4640138 Web: www.sjgov.or9/ed <br /> zo 7 <br /> PUBLIC RECORDS RELrEASE APPLICATION <br /> APPLICANT: Abby Racco euSINESSrAOI NCY: Neil 0. Anderson &Assoc, Inc. <br /> ADDRESS: 902 Industrial Way City/state/zip I Orel. CA`21 40 <br /> PHONE(1): 209-369-0376 PHONE(2): 120q-Z47-4420 FA0sI0LE: 209-369-4228 <br /> TENTATIVER APPOINTMENT DATE: November 6, 2008 Time:_ 8:00 AM W� <br /> (Please allow 10 business days from clato of application submittal-"'Pentativa only-mush be confirmed) _ _ <br /> CHECK 66X TO EXPEDITE REQUEST- 05 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ' DAT <br /> I <br /> Electronic Information: ❑ List❑ Map–Description: – _ -- <br /> FILE ADDREaS W..o. ... �. EH0�.•- USE ONLY W.Y..MWK4W <br /> Straot# Stroot Name <br /> city <br /> [j Unit 1 <br /> i.' 1.. 13371, N. Highway 99 Lodi E <br /> 2 . — �. .. d <br /> ❑ Un—it 2Ric <br /> 3. <br /> d, Unit 3 \ <br /> 6. <br /> I <br /> 5. <br /> in <br /> 4-Akiw is <br /> — — .__._.-._. . ---- _ ❑ <br /> units <br /> 9. <br /> I�_ _ _•.._.._.._. ...... ❑ Unit <br /> Specific Date Range of Information Requested:From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES !h IW <br /> IN UNDERGROUND TANK(UST)CLEANUP SITE(LOP) d HOUSING AoaTEPAENT C3SOLID WASTE FACILITYNEHICLL � I'� �v �,� � <br /> - <br /> 13 OTHER CLEANUP SITE{NON-LOP) CJ FOOD FACILITY ❑WA9TE:T IRT '„/� <br /> I?j UNDERGROUND TANK LIONITORINOIRENIOVAL) EJ DOG KENNr:L IY__L 0 DAIRY ,d <br /> ©HAZARDOUS WASTE GENERATOR 0 CHICKEN RANCH ❑WAs rEwATER TREATMENT PLAN'r <br /> LD TIERED PERMITTED FACILITY Cl MOTEL/HOTEL ❑PUMPER TRucK/YARD/CHEM TOILETS <br /> ❑TATTOO/BODY PIE=RCING ❑POOL/SPA M LAND USEAPPLICATION SITES <br /> q MEDICAL WASTE FACILITY ITY 0 OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC}PERMIT RECORDS ARE AVAILAnLE FOR REVIEW - MONDAY-FRIDAY 8:00 AM-6:00PM - EXCLUDING HOLIDAYS. <br /> 7. List up to ten addresses In the space above. Select the type($)of flies from the list above by checking the appropriate <br /> box(es). At least one file type MUST be selected. Fax to(205)464-0138 or mail to the address Indicated above Address, <br /> ranges will not be accepted—for additional assistance with file addresses,contact the i;HD. Applications received afior. <br /> 3:00 pm will be processed the next business day. <br /> 2, The EHD will notify the applicant if any EHD files exist. An appointment for review will be confirmed approximately tern(10) <br /> days after receipt of application. The files will be held for a maximum of five business days for review. Appointments I <br /> should be scheduled accordingly. <br /> 3. A file that Is actively being worked on by EHD staff inay not be Immediately available for review. A new application may be <br /> submitted when the fila is available. I I <br /> 4. Any file not returned In the same condition as released will be reorganized by EHD staff at the exponso of the applicant. <br /> Future file reviews by the same applicant may require a$106 deposit prior to review. <br /> ENL?USE ONLY <br /> EHD 48.06 8104/08 PUB IC RECORDS RELEASE APP FORM <br />