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From: 08/21#7 17:07 #729 P.001/001 <br /> na� [�LI 2094640136 ENVIRONMENTAL HEALTH <br /> PAGE 01/01 <br /> 01 EHD LOG NUMBER <br /> SAN JOAQUIN COUNTY <br /> AUG 2 9 2007 ENVIRONMENTAL HEALTH DEPARTMFNT <br /> 600 East Main Street,S(Dckton,CA 95202 '� <br /> ENVIROKIENT HEALT!-jelephone: (209)468.3420 Fax:(209)464-0138 Web:www.sjgox o <br /> PERMIT/SERVICES <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT:_ Lr�S -:w Z BUSINESS/AGENCY: ss; 1-1"G. <br /> ADDRESS: <br /> PHONE(1): �-V�7 �✓�.�'in l� I p tR): SFJ i �.�J__ D y5 .. <br /> TENTATIVE'APPOINTMENT DATE- <br /> Time: <br /> (PtDaS0211Ow 10 business days from date of application submittal-`TentabW only-must be confirmedo to <br /> CHECK BOX TO EXPEDITE REQUES S9rA FEE( N O CHECK ONLY)•REQUEST PROCESSED IN 3 BUSINESS DAYS �ry <br /> SIG ATURE OF APPLICANT DATE G +� <br /> Electronic lnformatlon: © List❑ Map-Description: <br /> _ FILE ADDRESS EHD USE ONLY <br /> Street# Street Name f city ❑ unit <br /> UAx GctK (�5 az <br /> 6�` 2 v-Lf(It7 /�✓�Gt `e- _ - D �GZ rGES(62 unit <br /> -or <br /> `7-6� 4 Z�jNJ . .. p�'Ci-G-i n.G ( r o( '6t �1 unR3 <br /> 2e Unll4 <br /> 6 `J,, � <br /> lLhh J��eY_ �O lv L��R {J 4M� �l <br /> © Unit S <br /> 72s L I Cv � <br /> Specific Date Range of Information Requested:From to \� <br /> ENVIRONMENTAL HEALTH DEPARTMENT FI S <br /> - M UNDERGROUND TANK(USS)CLEANUP SITE(LOP) El HOUSING ABATEMENT N WASTE FACLI E <br /> „E1�TryER CLEANUP SITE(NON-LOP) ❑FOOD FACRm TE T FIE <br /> \C�} UNDERGROUND TANK(MONITDRINWREMOYAL) ❑Doe KENNEL DAIRY <br /> \v HAZARDOUS WASTE GENERATOR ❑CHICKEN ❑WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITYEI <br /> MOTELfH ❑PUMPER TRUCKIYARD/CNEM TOILETS <br /> TATTOO/BODY PIEROINO 0 POOLISPA0 LAND USE APPUCATION SITES <br /> El MEDICAL WASTE FACILITY ❑OTHER(PL E SPECIFY) <br /> WELL AND SEPTIC PERMrr RECORDS ARE AVAILABLE FOR.REVIEW• MONDAY-FRIDAY 8:00 AM-8.00PM • EXCLUDING HQUDAYa, <br /> 1, List up to ten addresses in the space above. Select the types)of files from the Ilst above by checking the appropriate <br /> box(es). At)east one file typo MUST be selected. Fax to f202)484,0138 or mail 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 files exist. An appointment for review will be wnftrmed approximately ten(10) <br /> days after receipt of application. The fibs will be held for a maximum of five business days for reviow. Appointments <br /> 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 application may be <br /> submhted when the file is available. <br /> 4. Any file not returned In the same condition as released will be reorganised by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$05,00 deposit prior to review. <br /> END USE ONLY <br />