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07/25/2007 14:29 510-434-7676 PSI INC PAGE 02/02 <br /> 0 <br /> DAT v��Brr—_.:I ;A -F,:� EMO LOG NUMBER <br /> (�I '�/�C;�j 11°j i ;L� SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTII DEPARTME <br /> JUL 2 b Zoo 304 East Weber Avenue,3rd Floor, Stockton,CA 91S202 58 <br /> telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov. g <br /> ENVIRCi,A',,1F'd l Ht,ALM tw <br /> u)!GPS PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: ,I � r7 <br /> Y\� of )t- BUSINESS/AGENCY: ,✓Z <br /> ADDRESS: 170-s fir-�'F,INd'�tP Ave. 5ti 13 <br /> PHONE(1):J114 434 rIUO Cxk 13 PHONE(2): .- FACSIMILE:510 9391Q <br /> TENTATIVE'APPOINTMENT DATE: Fur)„ I LV} l b 4 Time: <br /> (Please allow 10 business days from de of application submittal-'Tentative only-must Iu: <br /> 26 CHECK BOX TO EXPEDITE nRE/QU,�ES//T-$03.00 FE (CASH OR CHECK tlNLY)-REQUEST PROCESSED IN -�`IN <br /> SIGNATURE OF APPLICANT 11Lri G-�„I..Y-- DATE <br /> UNIT DISTRIBUTION p Unit 1 O Unit 2 ❑Unit 3 ❑Unit 4 ❑Unit 5 n Unit 0 n Other(electronic/lists/maps) <br /> FILE ADDRESS <br /> street A: street Nam city EHD USE ONLY 0 <br /> wv/ 1• h1 <br /> D TI ^ <br /> L a �7hud•. S'k M1 <br /> LI <br /> p`r7. <br /> 8. <br /> 8. <br /> 10. <br /> Specific Date Range of Information Requested:From to <br /> T�,,,' ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> yAUNDERGROUND TANK(LIST)CLEANUP SITE(LOP) ❑HOUSING ABATEMENT n SOLID WASTE FACILIrYNEHICLE <br /> ❑OTHER CLEANUP SFE(NON-LOP) 13 FOOD FACILITY n WASTE TIRE <br /> ;UNDEROROUNO TANK(MONITORING/REMOVAL) C3 DOG KENNEL n DAIRY <br /> �MAIARDGU5 WASTE GENERATOR ❑CHICKEN RANCH C3 WASTEWATER TREATMENT PLANT <br /> O TIERED PERMITTED FAQUTY 0MOTEUHOTEL n PUMPER TRUCK/YARO/CNEMTOILErS <br /> n TATTOo/BODy PIERCING Cl PODLISPA n LAND USE APPLICATION SITES <br /> n MEDICAL WASTE FACILITY 0 OTHER(PLEASE SPEGFY) <br /> WELL AND SEP no PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIDAY 0:00 A.M-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 <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 ba processed the next business day. <br /> 2. The EHD will notify the applicant if any EHD flies 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 on 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 /> END M41U06 <br /> +114105 <br />