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� AP r. 15, 2008 4: 32PM Advanced GeoEnvi ronmental No. 1748EHDP 1 LIMBER <br /> MD SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMEN <br /> APR 1 0 2008 600 East Main Street, Stockton,CA 95202-3029 �� <br /> Telephone: (209)468-3420 Fax: (209)464.0138 Web: www, 'gov eh <br /> Di1ViRGl'�NEPi i HEALTH <br /> PER`01T(SERVICES PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT! h( c ,rai'�'Z4•�„ BUSINESS/AGENCY; 1 <br /> ADDRESS:? IL 37 Y //, <br /> PHONE(1): ` 6� 7-/D � k <br /> PHONE FACSIMILE: ,•7—JIl9' <br /> TENTATIVE`APPOINTMENT DATE; Time: <br /> (Please allow 10 business days from date of application submittal-'Tentative only-must be confirmed) <br /> 17 CHECK BOX TO EXPEDITE REQU �T-$98.00 FFEEE'LCASH OR CHECK ONLY)-REQUEST PROCESSED IN/3/BUSINESS DAYS <br /> SIGNATURE OF APPLICANT ' "i EC" a L1�i�_ DATE <br /> t.% <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street Name Clry ❑ unit 1 <br /> �ryfL O t4h cka <br /> - ear / 54r-1 f-Com- C1 l "' d 6 S 15 Unit 2 <br /> ) •1I(c (�CI'0.f'��vl.f't_ �Y 'f'f'Ft� ; {ti <br /> /.o�,}{�Ye�t,f�j � o�{t, <br /> 33 C- <br /> • _ �7o�cfY� ._`i�.4L.m�• 1 Slv�t .� <br /> I L /� --- ❑ Unit 5 <br /> � 9. <br /> 10. I0� units <br /> t( <br /> Specific Date Range of Information Requested: From to <br /> �\\ y( ENVIRONMENTAL HEALTH DEPARTMENT FILESjr <br /> �r UNDERGROUNn TANK JUST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT IWSOLID WASTE FACILITYNEHICLE <br /> L7 OTHER CLEANUP SITE(NON-LOP) - ❑FOOD FACILITY CI WASTE TIRE I I <br /> VUNDERGROUND TANK(MONITORING1REMOVAL) ❑DOG KENNEL 173 DAIRY <br /> HAZARDOUB WASTE GENERATOR Ok ❑CHICKEN RANCH Q WASTEWATER TREATMENT PLANT _I <br /> 0 TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑TATTOOMODY PIERCING ❑POOUSPA 177 LAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY Q OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 8:00 AM-$:00pm - EXCLUDING HOLIDAYS, <br /> 1. List up 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(2091464-0138 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 confirmed 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 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 /> submitted when(he file is available. <br /> 4, Any Nle not returned in the same condition a$released will be reorganized by EHD staff at the expense of the applicant <br /> Future file reviews by the same applicant may require a$98.00 deposit priorto review. <br /> EHD USE ONLY <br /> EHD 40-ee WEB e/KD07 <br />