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Mar 22 2005 4:58PM Ch&ley Consulting (20`668-2588 P.1 <br />DATE RECEIVED tru LUU NUMUtK <br />• SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />304 East Weber Avenue, 3' Floor, Stockton, CA 95202-2708 d {� I <br />2005 MAR 23 ' Toa fq(209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov.org/ehd <br />SAN 10AQUIN CrP"LIC RECORDS RELEASE APPLICATION <br />ADDRESS: <br />BUSINESSIAGENCY:CEShIF1I &1su � <br />O c4C1 I <br />PHONE (1): V (2 e—i_403 ,_PHONE(3):__4D2 FACSIMILE: &(010—Z510 <br />TENTATIVE' APPOINTMENT DATE: Time: <br />(Please allow 10 business days from date of appacaaon submftW .-Tentative only - must be confirmed) <br />CHECK BOX TO EXPEDITE REQ -593. SH OR CHECK ONLY)- REQUEST PROCESSED IN 3 BUSINESS DAYS <br />SIGNATURE OF APPLICANT 7 DATE ZZ ^ C-S- <br />Specific Date Range of Information Requested: From to - <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES I <br />�}1NOERGROUND TANK (UST) CLEANUP SRE (LOP) 173 HOUSING AaATEIAENT Y7$ OLID WASTE FAOLUTY1VEHI :LE <br />�THER CLEANUP SITE (NON -LOP) 173 FOOD FACILITY P WAGTE TRE <br />NDERGROUND TANK(MONITORiNGIREMOVAL) ❑DOG KENNEL e(DAIRY <br />,.,/HAZARDOUS WASTE GENERATOR 0 CMCKEN RANCH 0 WASTEWATER TREATMENT PLAIT <br />g TIERED PERMITTED FACILITY El MOTEUHOTEL ,O/ PumpERTucKIYARWCHEM TOILETS <br />0 +u TATTOOIBODY PIERCING 0 POOUSPA LEWD USE APPLICATION SITES <br />0 MEDICAL WASTE FACILITY 0 OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW. MONDAY.FRICAY a;00 AM-6:00PM - EXCLUDING HOLIDAYS. <br />1. List up to ten addresses in the apace above. Select the type(s) of fifes from the list above by checking the <br />appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0138 or mail to the address <br />indicated above. Address ranges will not be accepted -for additional assistance with file addresses, contact <br />the EHD. Applications received after 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 <br />approximately ten (10) days after receipt of application. The files will be held for a maximum of five business <br />days for review. Appointments should be scheduled accordingly. <br />3. A file that is actively being worked nn by EHD staff may not be Immediately available for review. A new <br />application may be 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 <br />applicant. Future file reviews by the same applicant may require a $93.00 deposit prior to review. <br />EHD.e@sae <br />ttn>ra <br />EHID USE ONLY <br />�iiiiini EL <br />��■�■ <br />mmim�rn����ia�u� <br />�����u � <br />Specific Date Range of Information Requested: From to - <br />ENVIRONMENTAL HEALTH DEPARTMENT FILES I <br />�}1NOERGROUND TANK (UST) CLEANUP SRE (LOP) 173 HOUSING AaATEIAENT Y7$ OLID WASTE FAOLUTY1VEHI :LE <br />�THER CLEANUP SITE (NON -LOP) 173 FOOD FACILITY P WAGTE TRE <br />NDERGROUND TANK(MONITORiNGIREMOVAL) ❑DOG KENNEL e(DAIRY <br />,.,/HAZARDOUS WASTE GENERATOR 0 CMCKEN RANCH 0 WASTEWATER TREATMENT PLAIT <br />g TIERED PERMITTED FACILITY El MOTEUHOTEL ,O/ PumpERTucKIYARWCHEM TOILETS <br />0 +u TATTOOIBODY PIERCING 0 POOUSPA LEWD USE APPLICATION SITES <br />0 MEDICAL WASTE FACILITY 0 OTHER (PLEASE SPECIFY) <br />WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW. MONDAY.FRICAY a;00 AM-6:00PM - EXCLUDING HOLIDAYS. <br />1. List up to ten addresses in the apace above. Select the type(s) of fifes from the list above by checking the <br />appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0138 or mail to the address <br />indicated above. Address ranges will not be accepted -for additional assistance with file addresses, contact <br />the EHD. Applications received after 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 <br />approximately ten (10) days after receipt of application. The files will be held for a maximum of five business <br />days for review. Appointments should be scheduled accordingly. <br />3. A file that is actively being worked nn by EHD staff may not be Immediately available for review. A new <br />application may be 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 <br />applicant. Future file reviews by the same applicant may require a $93.00 deposit prior to review. <br />EHD.e@sae <br />ttn>ra <br />