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04/09/2010�} /70 x9::�4����,4-```'� 9257469 AEI CONSULTANT PAGE 01/01 <br /> nggw1\ll IL-, EHD LOG NUMBER <br /> IIf^fa' \VY/ Ili SAN JbAQUIN COUNTY <br /> APR c ':010 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St. Stockton, CA 95202-3029 <br /> EWRONfJIEN T HEA9(dphone: (209)468-3420 Fax: (209)464-0138 Web: WWW.Sjgov.Org/ehd <br /> PERMIT/SERVICES PUBLIC RECORDS RELEASE APPLICATION / <br /> APPLICANT: ��� � BUSINESSIAGENCY: ����( E� L L.(m <br /> ADDRESS: 25LtD �� j�twb�o CITYISTATEIZIP: k-h141/� C {� C� 9llf5`1-7 <br /> PHONE(2) 0_411 FACSIMILE:�g�� --U <br /> PHONE(1): _ J1ap0 � y <br /> TENTATIV •APPOINTMEN ATE: Time: <br /> (Please allow 10 buainEas days from date of application submittal-'Tentative only•must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQUEST-$115 F SH OR CHECK O_NLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT DATE <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street 4 Street Name city ❑ unit t <br /> f. xl(a NoYq'lq M. cvn 5 2e z i NC No CO 5 <br /> 2. 2 Nori'h IMGuYI S1rte-F LDA 1pq Z t.0 <br /> U 5, G7/y in <br /> 3. 2 01 G& (R <br /> r� I I 'It; <br /> 4. 7-32-7-32- NJorIh Ir nn ai ru+ 3 AinUnits <br /> s. 23 Nor 12 ZDLK 1.ou s <br /> V 4r <br /> 6. 12 d �f LockeEr S'ff _ # Lu a{ enp units <br /> 7. <br /> (bH'2 L n0 <br /> s. Not-Z1 �C+WcDI. Z) acVo�yco <br /> *� Unit S <br /> LL�-- <br /> nits <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) ©HOUSING ADATEMENT SOLID WASTE FACIUTYNEHICLE /(J <br /> OTHER CLEANUP S17E(NON-LOP) ❑FOOD FACILITY ®WASTE TIRE �J VA UNDERGROUND TANK(MONRORINGIREMOVAL) [3 ,DOG KENNEL DAIRY 4/71 5YV A <br /> HAZARDOUS WASTE GENERATOR ❑CHICKEN RANCH WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY ❑MOTELIHOTEL PUMPER TRUCKIYARDICHEMICAL TOILETS <br /> TATTOOBODY PIERCING ❑POOUSPA ❑LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-5:00PM(EXCLUDING HOLIDAYS) <br /> 1. LisLgkLo to add sses in the space above. Select the type(s)of flies from the list above by checking the appropriate <br /> boxing). At least one file Type MUST be selected. Fax to(2091 464,0138 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 H any EHD files exist. An appointment for review will be confirmad approximately ten(10) <br /> days after receipt of application. The files will be held for a maximum of five business days for review. Appointments <br /> should be schoduled 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 /> 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 applicant, <br /> Future file reviews by the same applicant may require a$115 deposit prior to review. <br /> S. If you need further assistance,please contact Diane Martinez,at(209)468-8425. <br /> EHD use ONLY <br /> 7 2C <br /> n 13 53 cp l`(I <br /> EHO 4e.ae arznos <br />