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DATE RECEIVED EHD LUG NUMBER <br /> � SAN JOAQuiN COUNTY�; COUNTY <br /> ENONMENTAL HEALTH DEPARTMENT <br /> JUL12008 600 East Main Street, Stockton, CA 95202-2708 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.or <br /> EMJIRONMEW HEALTH <br /> PFRyrrrS_nVICEO PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: :J t -�`���`J C�-p�' BUSI <br /> /NE <br /> ESS/AGENCY: <br /> ADDRESS: D X `�' LI� 1 11iJ�o—y o �. CP Gly' Z C) I <br /> PHONE(1):�0 q� 93 O /O(� PHONE(2):_4�OI CM 00(I pl FACSIMILE: & 6 D- 2 2 1 <br /> TENTATIVE*APPOINTMENT DATE: Time: <br /> (Please allow 10 business days from date of application submittal-*Tentative only-must be confirmed) <br /> ❑ CHECK BOX TO EXPEDITE REQ ST-$98.00 FEE(CASH <br /> �OR }HECK ONLY)-REQUEST PROCESSED IN 3rBTUSINESS DAYS <br /> SIGNATURE OF APPLICANT u \}!„�X DATE / O <br /> Electronic Information: ❑ List❑ Map-Description: <br /> FILE ADDRESS EHD USE ONLY <br /> Street# Street Name City Unit 1 <br /> 1' 1. LS P <br /> 2. LA '.3 0 ( (.I.(AJ I "o Unit 2 <br /> 3. L (6161' <br /> \ <br /> 4 Unit 3 <br /> 5. <br /> Unit <br /> 7. V1 V 1 <br /> unit5 <br /> 8. <br /> 9. <br /> Unit 6 <br /> 10. <br /> Specific Date Range of Information Requested: From to <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES <br /> UNDERGROUND TANK(UST)CLEANUP SITE(LOP) HOUSING ABATEMENT SOLID WASTE FACILITYNEHICLE <br /> OTHER CLEANUP SITE(NON-LOP) FOOD FACILITY WASTE TIRE <br /> UNDERGROUND TANK(MONITORING/REMOVAL) DOG KENNEL DAIRY <br /> HAZARDOUS WASTE GENERATOR Id CHICKEN RANCH ,,�ff WASTEWATER TREATMENT PLANT <br /> TIERED PERMITTED FACILITY "OTEL/HOTEL L"y PUMPER TRUCK/YARD/CHEM TOILETS <br /> TATTOO/BODY PIERCING -II POOLISPA RAND USE APPLICATION SITES <br /> MEDICAL WASTE FACILITY @ OTHER(PLEASE SPECIFY) <br /> WELL AND SEPTIC PERMIT RECORDS ARE AVAILABLE FOR REVIEW - MONDAY-FRIOAY 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$98.00 deposit prior to review. <br /> EHD USE ONLY <br /> If you should need further assistance please contact Diane Martinez @ (209)468-3425 directly. Thank You*** <br /> EHD 4846 911412006 <br />