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DATE RECEIVED _ <br /> -- SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web: www.sjgov.o <br /> PUBLIC RECORDS ((( <br /> RELEASE APPLICATION <br /> APPLICANT- <br /> ADDRESS: �j�7�jJ 16�' C7—` BUSINESS/AGENCY: <br /> PHONE(1): PHONEJ <br /> (2)I FACSIMILE: <br /> TENTATIVE"APPOINTMENT DATE: <br /> (Please art"ton business days from date f applleatlon submittal-•TenWf"only)me;-In be can ; <br /> f� CHECK BOX TO EXPEDITE REQUEST•E98,00 FEE(CASH OR CH K ONLY)-REQUEST PROCESSED IN THREE SINESS DAYS <br /> SIGNATURE OF APPLICANT ��/�----�G+��� <br /> Electronic DATE <br /> Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS <br /> Street street Name ,cry EHD U5E ONLY <br /> 1, f Se�77�' p9 I I <br /> OE 7,NOLO/Sy �Unit7 <br /> 2. <br /> 3. �9 No un,i 3��NO W!5; N ff- ❑unit 2 <br /> 4. <br /> 5. t <br /> 6. <br /> nk3 \nL <br /> 7. Unit 4 <br /> B. <br /> 9. ❑Units <br /> 10. <br /> ❑Unit 6 <br /> Specific Date Range Of Information Requested:From <br /> to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> OZEREO <br /> NDERGROUND TANK(UST)CLEANUP SITE(LOP) 0 THER CLEANUP SITE(NON-LOP) HOUSING ABATEMENT0 SOLID WASTE FACILITYNEHICLEDERGROUND TANK(MONITORINGJREMOVAL 0 FOOD FACILITY WASTE TIRE ZARDOUS WASTE GENERATORT" ODDG KENNEL �DAST ,-3/'�. <br /> PERMITTED FACILITY 0 CHICKEN RANCH ❑WASTEWATER TREATMENT PLANT r'—' <br /> 0 TATTOoftoy PIERCING ❑MOTEL/HOTEL ❑PUMPER TRUCKIYARDICHEM TOILETS <br /> NP:wDICAL WASTE FACILITY({ 0 POOL/SPA ❑LAND USE APPLICATION SITES <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOROTHE REVIEW(PLEASE SPECIFY) <br /> 1. List up to ten addresses In the space above. Select tho MONDAY-FRIDAYfliesromt 8:00 AM-6:00pM - EXCLUDING HOLIDAYS. <br /> box(e9). At least one file (s)of files from the list above try checking the appropriate <br /> not be Accepted-for additionaMasaistanDerw th(�le addresses 4c 4.0138 er m i)to the <br /> --ct the��Q,bove addmss, Address ranges will <br /> bo processed the next business day, contact the EHD. gppllcations received after 3:00 pm will <br /> 2. The EHD will notify the applicant if any EHD flies exist, An appointment for review will be confirmed Approximate) <br /> days after receipt le application. The Flies will be held fora maximum of Rve business days far review, Appointments <br /> should to Scheduled accordingly, y ten <br /> 3. A fue that Is actively being worked on by the EHD staff may not be Immediately available for review. A new <br /> tion <br /> may be submlfted 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$98.00 deposit prior to review. <br /> EHD.USE ONLY <br /> ffEH04M6 I zemi <br /> P "V'FCOKD RELERSEAPPF RM <br />