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i ca 1/Hi i ca I Con PHONE NO. : 510 6548605- JUL. 07 2011 OB:45AM P1 <br /> 11 SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main St, Stockton, CA 95202-3029 'n <br /> ENVIRONMENTALHE16'rPepnone: (209) 468-3420 Fax: (209) 464-0138 Web: www,s ov.or /ehd a <br /> PERMITISERVICE 19 5 ���{/// i? <br /> PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: Irl— � BUSINESSIAGENCY:Aeew-T���7 <br /> ADDRESS: CITY/STATE/Zip: 0/� / � <br /> PHONE(1): PHONE(2): FACSIMILE:17CO W--L�L (� S <br /> TENTATIVE'APPOINTMENT DATE: '2 UL y S 20l ( Time: f=o o /dq <br /> (Please allow 10 business days fromdam Of OPptication tubmIttal-"TenfaGve only•must be confirmed) <br /> ❑CHECK BOX TO EXPEDITE REQU T-$122 FEE(CAS(1 OR CH LY)-;REQUEST PROCESSED IN 3 BUS NESS DAYS <br /> SIGNATURE OF APPLICANT /l/9// DATE 7 <br /> Electronic Information: © List 0 Map—Description: ' <br /> FILE ADDRESS EHD USE ONLY } <br /> l/{( Street 0 Street Name city Unit' <br /> ®V" /UO ny. <br /> 2• � �� S• GePCcF « Iv Unit2 <br /> 9. Lf C7 LEK7C/j4. v <br /> nit3 <br /> 5. <br /> 6. 1F(F S Glc P Unit4 <br /> Z 3 k11�, So/t iP c c U , DE5 <br /> 8. LVl SO ©� Unttt <br /> S. cE S_ & L P o cr �Za U <br /> po cT Unit <br /> $PacMc Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES fi 52�� <br /> ^� <br /> 2r�1kDERGROUNO TANK(UST)CLEANUP SITE(LOP) El HOUSING ABATEMENT []SOLID WASTE FAGLTTYNEHICLE (1 <br /> L�TOiGHERCLEANUP SITE(NON-LOP) ©FOOD FACILITY WASTE TIRE Lw,4%., <br /> UNDERGROUND TANK(MONITORINGIREMOVAL) ❑DOG KENNEL ❑DAIRY -T, I-1-1) <br /> 914AZARDOUS WASTE GENERATO� [I CHICKEN RANCH El WASTEWATER TREATMENT PLANT L <br /> ©TIERED PERMITTED FACILITY ❑MOTELIHOTEL ❑PUMPER TRUCKIYARD/CHEMICAL TOILETS <br /> © <br /> TATTOO/BODY PIERCING ❑POOL/SPA ❑LAND USE APPLICATION SITE$ <br /> ❑ MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW: MONDAY-FRIDAY 8:00 AM-S:OOPM(EXCLUDING HOLIDAYS) <br /> 1. Ust up to ten addresses in the apace 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 to(209��138 or mail to indicated�veor mail to�g�ddmss indicated�ve. 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 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$122 deposit prior to review. <br /> we USE ONLY <br /> e rrmna <br />