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`v: �� ttiA �VY400[y YY b.Jc Yu411C Works <br /> 001/001 <br /> SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> AUG 14 2009 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-2708 <br /> ENVIRONMEN T HE "hone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/eh 070 <br /> PERNIMSERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: �a G- <br /> �'— BUSINESS/AGENCY: :S��� P <br /> ADDRESS: ��� ��> e��� Ayertttt_. CITY/STATE/ZIP: <br /> PHONE(1): ;1.0� -.114 81— 3085' PHONE <br /> PHONE(2): FACSIMILE: -Zet `168 <br /> TENTATIVE*APPOINTMENT DATE: <br /> (Please allow 10 business days from date of application submittal-*Tentative only-m st be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$115.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT I -- <br /> DATE S/ <br /> Electronic Information: ❑List❑Map—Description: <br /> FILE ADDRESS <br /> I Street# Street Name EHD USE ONLY <br /> f 1. City <br /> IiY eL✓ p <br /> � ( Unit <br /> 2. 74 (� c5�t�1 G� (� Floq� <br /> nit 2 <br /> 4. <br /> 5. 6I Awar c` Unit3 <br /> s. 2 3So.►�+a c 1�-c A C'C o.1 <br /> 7. ) Unit <br /> 8. S <br /> �OL <br /> 9. Unit 5 <br /> Specific Date Range of Information Requested: From ❑Unit 6 <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES to II nl <br /> &UNDERGROUND TANK(UST)CLEANUP SITE LOP OV V <br /> ( ) FDOOOG <br /> OUSiNG ABATEMENT Q SOLID WASTE FACILITYNEHICLE <br /> ,OTHER CLEANUP SITE(NON-LOP) D FACILITY <br /> UNDERGROUND TANK(MONITORING/REMOVAL)pt\ KENNEL ❑WASTE TIRE / <br /> HAZARDOUS WASTE GENERATOR ` ElDAIRY ' 4 C ( <br /> ❑TIERED PERMITTED FACILITY ❑CHICKEN RANCH ,�ASTEWATER TREATMENT PLANT I <br /> ❑ El MOTELIHOTEL TATTOOIBODY PIERCING ❑ %PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> El MEDICAL WASTE FACILITY �-1 ❑LAND USE APPLICATION SITES <br /> (PLEASEOTHER <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. List un 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 ass <br /> 3:00 pm will istance with file addresses,contact the EHD. Applications received after <br /> 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 ten(10) <br /> days after receipt of application. The files will be held for a maximum of five business days for review. A <br /> should be scheduled accordingly. ppointments <br /> J3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new a <br /> submitted when the file is available. application o may be <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense of the applicant. <br /> Future file reviews by the same applicant may require a$115.00 deposit prior to review. <br /> EHD USE ONLY <br /> ***If*needfUrther assistance plee contact Diane Martinez @ (209)468-3425 directly. Thank You*** <br /> 00 ajrz 5 I y8 3 <br /> EHD 4806 <br /> 7131/2009 <br />