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01/09/200H 15:01 209334 <br /> WGR SOUTHWEST NCO PAGE 01/01 <br /> DATFy [D E :,ip� ,-?^ EHD LOG NUMBER <br /> (isl ( ,; SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> j 0 200$ 600 East Main Strect, Stockton,CA 95202-3029 <br /> Telephone:(209)468-3420 Fax: (209)464-0138 Web:www.aj py.or <br /> I'�ji1;t�Uj`• �'I I�'V� r(L"h�Tl Z7 <br /> Q(,r!T!HP.V t,F! PUBLIC RECORDS RELEASE APPLICATION <br /> APPLICANT: CA <br /> ltI "" IS-HC'e�J� BUSINESS(AGENCY: IL(A)GSDUTj4W'eSf_ <br /> ADDRESS: --11( W . V i 'e✓ 5 Zees- Sut'TQ- W D Z. C.A <br /> PHONE(1):cW�l 3 N - 53 63 PHONE�(2); 6 rcG�o FACSIMILE'l.�c{ -7i J� '5374 <br /> TENTATIVE*APPOINTMENT DATE: JIAn a-� 2�Q q Time: /0 Ain <br /> (Please allow 10 business days from date of application submittal-"Tentative only-must be confirmed) <br /> ❑ CHECK DOX TO EXPEDITE REQU ST-$98.00 FEE(CASH OR CHECK ONLY)-REQUEST PROCESSED IN S B)JSINESA DAYS <br /> SIGNATURE OF APPLICANT DATE D <br /> Electronic Information: ❑List❑Map'-Description: r b I � <br /> ( �) <br /> (ly FILE ADDRESS EHD USE ON Y <br /> l,�`�fIJ' <br /> Street It Street Name Clly p � s " dl ❑ Unit 1 <br /> ,. 5l 5 av %vC 5 Uk� dw .2 &_C(t)) <br /> • 35175 &V L1>ze S b+ —�" L .'Sm 11Lv a1) AA)d IU 2 <br /> 3. 3 0 orifi—p b X526 JnrF6 q4 i <br /> Unit 3 <br /> 4• 0'S W • F -P, Shr 3 1Sh7y) I_Li <br /> 5- NI✓ 03,) -:Tvry <br /> 6• Unit 4 <br /> \\ ❑ units <br /> 9. <br /> units <br /> 10. <br /> Spec Date Range of Information Requested:From /k L t, to fa l J <br /> ENVIRONMENTAL HEALTH DEPARTMENT FILES �, ,n i{3 <br /> OERGROUND TANK(UST)CLEANUP SITE(LOP) O HOUSING ABATEMENT UD WASTE FACILMNEHICLE ` U• 'I n�1 <br /> ,ETH ER CLEANUP SITE(NON-LOP) 13 1700D FACILITY �tSTETWE r <br /> 7UNOERGROUND TANK(MONITORINOIREMOVAL)t/ ❑DOG KENNRL i7 DAIRY <br /> HAZARDOUS WASTE GENERATOR,/ ❑CHICKEN RANCH ❑WASTEWATER TREATMENT <br /> 13 TIERED PERMITTED FACILITY ❑MOTEL/HOTEL ❑PUMPER TRUCK/TARDICHEM TOILETS <br /> r7 TATTOO/BODY PIERCING In PD USPA ❑LAPD USE APPLICATION SITES <br /> Cl MEDICAL WASTE FACILITY 13 OTHER(PLEASE SPECIFY) <br /> WELL AND$EPTIC PERMIT RECORDS ARE AVAILABLE FOR REvu:W -MONDAY-FRIDAY 8:00 Aw5:00PM -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.Appilcations received after <br /> 3:00 pm will he 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 flies 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 now 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 scan 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 /> 3 ctu - Z <br /> 3�rvy;� JJ4V 41 4 Z <br /> 7G5 _ <br /> IU42 TP i +2 <br /> Elm�eua orenoar <br />