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huir-21-07 14:10 From-BROWN A' ALDWELL 916 635 880if <br /> T-832 P 002/002 F-961 <br /> k6e*`((I �'l�\V//lm SAN JOAQUIN COUNTY EHD LOG NUMBER <br /> AUG 2 ENVIRONMENTAL HEALTH DEPARTME <br /> 2007 600 East Main Street, Stockton, CA 95202-3029 I <br /> ENVIRMNIENT HEALTH{ elephone: (209)46$-3420 Fax: (209)464-0138 Web: www.sjgov. / <br /> PERMIT/SFRVICES PUBLIC RECORDS RELEASE APPLICATION �y n,r <br /> APPLICANT: 1. ' t� b��VV / L Q /7�B�UESIINEES,SIA�Gr,Er7N�C�Y,: n- /�W tJ+ C/\-W l <br /> ADDRESS;q1f0-15 Q� v�,{�1't 1'1'X_ 1 SU116- IUD K-,k\NVl�t1'� WPV0\1!1 C- q5LO lD <br /> PHONE(11):91U V7�— S JSI PHONE(--2))'; \\1ff��I''ID/�1�V�y, ZL4- _FACSIMILE_ <br /> TENTATIVE`APPOINTMENT DATE!Tye U— �f t' Time: Ib :00A t <br /> (Please allow IU business days from date of a Hcati n submittal-`Tentative only-must be confirmed) <br /> O CHECK BOX TO EXPEDITER QUEST-$98.00 F E(CASH OR CHECK ONLY)-REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICAN DATE 15 -2-1 O_] <br /> Electronic Information: ❑ List❑Map-Description: <br /> FILE ADDRESS _ EMD USE ONLY <br /> Street# Street Name city (,{ 02 ❑ Unit t <br /> �Or`Eh 5l rt b . SkbLV_nI <br /> z. 898 W�S� reirnon 5-{- .1iTbG� �bN u5T unnz <br /> 3. <br /> W 4. Unit 3 <br /> t 5. <br /> 6 unit 4 <br /> 7. <br /> $ ❑ Uni[5 <br /> 9. <br /> ❑ unit 6 <br /> 10. <br /> Specific Date Range of Information Requested:From _ OLV I to all <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> gTINDERGROUNDTANK(USTI CLEANUP SITE(LOP) C3 HOUSING ABATEMENT ❑SOLID WASTE FALILTTYNEHICLE <br /> MIOTHER CLEANUP SUE(NON-LOP) ❑FOOD FACILITY 13 WASTE TIRE <br /> Er U NDEAGROUND TANK(MONTTORINWREMOVAL) ❑DOG KENNEL 0DAIRY <br /> O'HAZARDOVS WASTE GENERATOR ❑CHICKEN RANCH ❑WASTEWATERTREATMENT PLANT <br /> In TIERED PERMITTED FACILITY ❑MOTEL/HOTEL ❑PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑TATroc/BODY PIERCING ❑POOUSPA M"LAND USE APPLICATION SITES <br /> 173 MEDICAL WASTE FACILITY ❑OTHER(PLEASE SPErjrY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE TOR REVIEW - MONDAY-FRIDAY 8:00 AM-5:00PM - 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(209)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 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$96.00 deposit prior to review. <br /> EHD USE ONLY <br /> EHDG 14Z WEB&82007 <br />