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05/31/2006 WED 10;44 FAI 55407 2886 BSK Environmental . U002/002 <br /> OA E� V ED SAN JOAQUIN COUNTY EHD LOG NUMEER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> MIA'( 3 <br /> t boas 304 East Weber Avenue,3d Floor,Stockton,CA 95202-2708 q3jENVIRONMENT HEXLle "ne: (209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATIOpN� <br /> APPLICAtn': MCC 1-(tllEhl'2.1C SUSINESSIAGENCY: UMC A.S C6L1ATt�__� <br /> ADDRES.:_ W- ,SHAW AUCNV6I !Law- EA.,sAai CA ?37o4/ <br /> PHONE(l): 554. `/77.2,356 12--_117-) PHONE(21: !r59. V79. 791577 FAcsomLE: .Sj . 4 - ZPf 4 — <br /> TENTATNE•APPOINTMENTDATE: &//Y/O(0 Time: fQQ�'I <br /> (Please allow 10 buainass days from date Of appliCatlon submittal-'TeRGlfve only-must be oogfirmed) <br /> 13 CHECK BOX TO EXPEDITE R ESy7.$93.00 E N OR CHECK ONLY)-REQUEST PROCESSED INS BUSINESS DAYS <br /> SIGNATURE OF APPLICANT GW / DATE P13,916 <br /> d <br /> UNtt DtSTRtBU170N O Unitl - ❑UnRF 1IUnK3 ❑Umt4 M UnitS 0 Daae MRUIor(elecVonirlli5te.hLNAps1 �� <br /> FILE ADDRESS <br /> _ ma <br /> F4. <br /> udy <br /> Jyff <br /> Too t, /VA"PAW0-nIA✓Y,_49.12tE 2_? NA I/'r_�rl�4E <br /> 9. <br /> 10. 4 - <br /> Sp-ciftc Date Range of Information Requested:From to e __ <br /> y ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> }A UNDERGROUIID TANx(UST)CLEANUP Sire(LAP) ❑HOUSING ABATEMENT 13 SOLM WASTE FAIAMIVENICLE <br /> r��OTHER CLEANUP SITE(NON10P) ❑Fpoo F/KKm O WASTE TIRE <br /> TYUNmROUND TANK(MONnORINWREMOVAL) t]DOG KENNEL 0 DAIrn' <br /> rUIZARDOUSWASTEGCMMTOR 17 CHICKEN RANCH ❑WMTE Anm TREATMENT PLANT <br /> •``���,,... <br /> TIERED PERMITTED FACILRY ❑MOWLIHOTEL ❑PUMPERTRVCKIYA WCHEH T011XT3 <br /> El TATTOO)BWy FERQNG ❑POOLISPA O LAND ME APPLICA"N Wr`S <br /> MEIXCAL WASTE FACILITY P OTHER(PLEASE SPEQF'() <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW- MDNDAYFRIDAY S-W AM-5;0Q?" - EXCLUDING HOUDAYS. <br /> 1. List up to ten addresses In the space above. Select the type(s)of files from the list above by checking the <br /> appropriate box(es). At least one file type MUST be Selected. Fax to(209)464.0135 or mall 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 files exist An appointment for review will to 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 /> appl"station 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 /> EHP•aayo W <br /> vamp <br />